Many previous series reporting the construction of Brescia-Cimino fistulae in children describe a high rate of immediate and late patency failure. Using microsurgery, we have constructed 23 Brescia-Cimino fistulae in 23 children, 10 weighing less than 20 kg and 13 weighing more than 20 kg. An immediate patency rate of 100% was achieved in both weight groups with a late patency rate of 90%-100%, in those under and over 20 kg, respectively. We recommend using microsurgery for all such angioaccess procedures.