Arteriovenous fistula analysis sound of two cases. The first case is arteriovenous fistula construction resulting from acute renal failure. The puncture began two weeks later. Immediately after creation, the initial sound had a small hardness component due to the influence of a vasospasm. In the second case, an arteriovenous fistula was constructed after a long history of diabetes. The puncture began three weeks later. In both cases, it was observed that the arteriovenous fistula sound was hard at the beginning, even when the arteriovenous fistula sound developed, and that the ratio of random intermittent and harmonic sounds due to the start of puncturing increased.