In line with the growing interest for studying apoptosis in blood vessels, this study is one of the first to assess the apoptosis in native veins used for arteriovenous fistulas (AVF) done for hemodialysis. The aim of this study was to evaluate apoptosis in previously punctured native veins (study groupy) compared with not punctured native veins (controls) in patients who undergo a surgical procedure for AVF as dialysis access. Cephalic vein specimens were obtained from 60 patients before the placement of AVF. Half of the specimens were from the previously punctured and half from non-punctured veins. A 1-cm long segment was excised from distal part of the cephalic vein, divided into two portions along longitudinal axis and prepared for immunohistochemical analysis. Immunohistochemical assessment and quantification of signals was used to evaluate the expression of Bax, p53, caspase 3 and Bcl-2. Vein specimens from the study group with previously punctured veins showed significantly increased caspase 3 and Bax expression, compared with the control group (p<0.01). Bcl-2 expression in the study group was significantly decreased compared with the control group (p<0.01). p53 showed no significant differences between the two groups (p=0.791). There were statistically significant differences in fistula failure between the study group and control group (26.7% versus 6.7%, p=0.038). The association we have found between previously punctured veins and apoptosis indicates the role that venipuncture may play in the development of apoptosis. Patients with increased apoptosis showed an increased fistula failure, which is of importance for the improvement of the AVF procedure itself.