A V fistula creation in patients with chronic kidney disease is challenging in the setting of previous failed fistulas, thrombosed cephalic veins. Distal fistula creation is the preferred site so that the proximal options are available if the distal fistulas fail. Basilic vein transposition is commonly done in the arm. The purpose of this study is to present the technique of Basilic vein transposition in forearm proving beneficial in preserving the proximal options for AV fistula creation in patients with thrombosed cephalic vein, small calibre cephalic vein and failed distal AV fistulas.