Cephalic vein exteriorization AV access in ESRD multiple access failure and morbid obese patient. AC access for dialysis becomes necessary for kidney failure patients. We had one such patient who was morbidly obese. Due to long standing double lumen catheter all the great veins were exhausted. Both side upper limb had small basalic veins. Only possible vein for access was left Cepahalic. However, due to obesity the vein was deep. We planned left BC AVF with simultaneous exteriorization of cephalic vein segment.