BACKGROUND: The effective management of vascular access (VA) is pivotal in hemodialysis (HD) care, with nurses assuming a key role in this crucial process. Nonetheless, there is a noticeable gap in our understanding of the knowledge, attitude, and practice (KAP) of nurses concerning arteriovenous fistulas (AVF) for HD. This study aimed to investigate the KAP of nurses in this domain. METHODS: This multi-center cross-sectional study was conducted in 42 hospitals from April 11, 2023, to June 11, 2023. Participating nurses completed a self-administered questionnaire providing demographic and KAP information. Structural equation modeling (SEM) was utilized to assess the interrelationship between KAP. RESULTS: A total of 450 valid questionnaires were included in the analysis. The knowledge, attitude, and practice scores were 12.70 ± 1.42 (84.6%, possible score: 0-15), 44.37 ± 2.76 (88.7%, possible score: 10-50), and 56.73 ± 6.61 (87.3%, possible score: 13-65), indicating that adequate knowledge, positive attitude, and proactive practice. Knowledge had a direct influence on both attitude (β = 0.42, 95% CI: 0.24-0.59, CONCLUSION: The findings revealed that HD nurses exhibited adequate knowledge, positive attitude, and proactive practice concerning AVF for HD. Notably, their level of knowledge directly influenced both their attitudes and practices, while also exerting an indirect influence on the latter.