Hand pain is a common complaint in the hemodialysis patient on arteriovenous fistula. The problem is related to its etiology: nervous or vascular, which requires different therapeutic solutions. Ischaemic etiology involves a deviation of the distal flow in the anastomosed vein, with the decrease of the distal flow and the installation of distal ischaemia. Nerve etiology involves compression of the median nerve in the carpal tunnel. The purpose of the paper is to present a case study of diagnosis and treatment of median nerve compression in hemodialysis patient.