Objective: To investigate the application value of ultrasound-guided transcatheter thrombolysis combined with high pressure balloon for acute occlusion in forearm arteriovenous fistulas (AVF) patients. Methods: In the retrospective analysis, transcatheter thrombolysis with high pressure balloon dilatation were performed under ultrasound guidance in 10 patients with acute occlusion of forearm AVF as operation group. Meanwhile data of 20 patients whose AVF used commonly in hemodialysis as control group was collected. The patency rate of AVF at 1 ,3 ,6 months were studied. The vessel internal diameter and the peak systolic velocity (PSV), the blood flow of brachial artery were compared in the pre- operative and post-operative patients and control group. Results: In 10 patients of operation group, ultrasound-guided transcatheter thrombolysis with high pressure balloon dilatation were successfully performed. After follow-up for 6 months, 1 patient had recurrent stenotic lesion, none of patients had recurrent occlusion. It showed a significant increase in the vessel internal diameter and blood flow and a significant decrease in PSV after the procedure. Conclusons: Ultrasound-guided transcatheter thrombolysis with high pressure balloon is a feasible method for acute occlution in forearm AVF patients.