Abstract：Objective：To observe the effect of Huoluo Ointment applied topically in patients with stage 5 chronic kidney disease（CKD）undergoing maintenance hemodialysis after autologous arteriovenous fistula（AVF）surgery. Methods：A total of 60 patients with Stage 5 CKD undergoing maintenance hemodialysis and treated with AVF at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from February 2023 to August 2024 were selected and divided into a treatment group and a control group，with 30 cases in each group，using a random number table method. The control group received conventional therapy after AVF surgery，while the treatment group was given Huoluo Ointment applied topically in addition to conventional therapy，with treatment continuing until the end of the 8 th week post-surgery. The efficacy of traditional Chinese medicine syndrome，fistula maturation rate，traditional Chinese medicine syndrome scores，pain severity [Visual Analogue Scale（VAS）]，fistula function indicators [cephalic vein diameter，cephalic vein blood flow，resistance index（RI），and distance from the skin]，vascular elasticity，vascular bruits，incidence of complications，and safety were compared between the two groups. Results：The total effective rate of traditional Chinese medicine syndrome efficacy in the treatment group was 96.67%（29/30），and the fistula maturation rate was 90.00%（27/30），both higher than those in the control group at 73.33%（22/30）and 63.33%（19/30）， respectively（P＜0.05）. At four weeks post-surgery，traditional Chinese medicine syndrome scores and VAS scores in both groups were decreased compared to the day of surgery（P＜0.05），with the treatment group achieving lower scores than the control group（P＜0.05）. At eight weeks post-surgery，traditional Chinese medicine syndrome scores and VAS scores in both groups were decreased compared to four weeks post-surgery（P＜0.05）， with the treatment group achieving lower scores than the control group（P＜0.05）. At four weeks post-surgery，the cephalic vein diameter and blood flow was increased（P＜0.05），and the distance from the skin was decreased（P＜0.05）in both groups compared to the day of surgery；the treatment group had a larger cephalic vein diameter and blood flow and a shorter distance from the skin than the control group（P＜0.05）. At eight weeks post-surgery，the cephalic vein diameter and blood flow were increased（P＜0.05），and the distance from the skin was decreased（P＜0.05）in both groups compared to four weeks post-surgery；the treatment group had a larger cephalic vein diameter and blood flow and a shorter distance from the skin than the control group（P＜0.05）. At four and eight weeks post-surgery，the treatment group had a lower RI than the control group（P＜0.05）. At eight weeks post-surgery，the treatment group had better vascular elasticity（90.00%， 27/30）and weaker vascular bruits（83.33%，25/30）compared to the control group（63.33%，19/30 and 56.67%， 17/30，respectively）（P＜0.05）. The incidence of complications in the treatment group was 10.00%（3/30），lower than that in the control group at 33.33%（10/30）（P＜0.05）. No significant adverse reactions occurred in either group. Conclusion： The application of Huoluo Ointment topically in patients with Stage 5 CKD undergoing maintenance hemodialysis after AVF surgery is significantly effective. It can improve fistula maturation，alleviate symptoms，relieve pain，enhance fistula function，increase vascular elasticity，reduce vascular bruits，and decrease the incidence of complications，with high safety.