The use of various techniques to regularly monitor for arteriovenous access stenosis has become standard practice in many dialysis units. The hope is that we can intervene on early stenotic lesions before the development of thombosis and eventual graft failure. However, the available data questions the practice of routine surveillance over clinical monitoring. Many arteriovenous grafts will eventually fail and thrombose with normal studies and others with positive studies and no stenosis will lead to invasive procedure potentially jeopardizing the graft itself. However, the practice will save a few grafts from thrombosis.