In patients on hemodialysis for uremia, there are often varying degrees of unilateral hand and limb swelling, especially after hemodialysis. Some patients may think that it is a “side effect” of dialysis and do not pay attention to it, but over time, the swelling of the upper limbs will become more and more aggravated, and gradually pain, insufficient dialysis flow or even swelling extending to the head and face will occur. So what should I do if I encounter swelling of the upper limbs after dialysis? First, we need to determine the type of dialysis the patient is on. It takes more than 6 weeks to mature for an initial autologous cephalic-radial artery endovascular fistula and more than 3 weeks for an artificial vascular endovascular fistula. The swelling of the upper extremity that occurs after the procedure is normal, and the swelling usually subsides in 5-7 days. If the patient has been using an internal fistula or an artificial endovascular fistula for a period of time and has “swollen hands”, it is important to be alert to central venous stenosis. The central vein, which includes the subclavian vein, the cephalic vein (saphenous vein), and the superior vena cava, is the main artery of the dialysis pathway that carries blood back to the heart. Central vein stenosis or occlusion is a common complication after arteriovenous endovascular fistula in hemodialysis patients, which manifests as 1. swelling of upper limb extremities and/or chest wall and neck and face 2. difficulty in endovascular fistula puncture 3. abnormal dialysis flow 4. ischemia and rupture of fingertips. According to foreign literature, 80.5% of patients with central venous stenosis present with these clinical manifestations, and the majority of them have a previous history of ipsilateral temporary or long-term dialysis catheter placement. Central venous stenosis greatly affects the use of hemodialysis access and its lifespan, deepens patient suffering, and is a difficult clinical problem to treat while providing symptomatic relief and preserving hemodialysis access as much as possible. Previously, the treatment of swollen hand syndrome mostly used ligation of arteriovenous endovascular fistula to reduce the postoperative return blood volume, and the swelling would be gradually relieved. In recent years, the method of percutaneous puncture endovascular treatment has been gradually applied in the clinic to treat central venous stenosis by balloon dilatation and stent implantation, which can alleviate the clinical symptoms of patients while preserving the hemodialysis access, so that more uremic patients can benefit from it. In conclusion, for every uremic dialysis patient, every vein on the body may become a “life-saving” line in the future. If unexplained upper limb swelling and dialysis flow abnormalities occur during dialysis, please promptly inform the nephrologist or vascular surgeon for early treatment.