The authors report a case of iatrogenic brachial arteriovenous fistula (AVF) on the left arm in a 20-year-old man with a history of autosomal dominant polycystic kidney and failing kidney transplant. An attempt to create vascular access for hemodialysis by utilization of an existing iatrogenic brachial AVF was undertaken. The patient underwent surgical superficialization of a concomitant enlarged and deeply located vein. Four weeks after the procedure, the AVF was successfully cannulated for hemodialysis. In this case, iatrogenic/congenital AVF was successfully converted to vascular access for hemodialysis.