Objective To explore the clinical application and clinical efficacy of Fogarty catheter thrombectomy combined with high-pressure balloon intraluminal angioplasty in elderly hemodialysis patients with stenosis and thrombosis in autologous arteriovenous fistula. Methods A total of 42 elderly hemodialysis patients who underwent thrombus removal with Fogarty catheter and high-pressure balloon angioplasty at the same time in the hybrid operating room of Yibin First People′s Hospital from March 2018 to March 2019 were recruited in this study. Their clinical outcome, complications, patency rate and its influencing factors were analyzed. SPSS statistics 22.0 was used for data analysis. Breslow test was used to analyze the factors influencing the postoperative fistula time after hybrid surgery, and Cox risk regression analysis was employed to analyze the factors influencing the patency rate of postoperative fistula. Results The success rate of operation was 95.24% (40/42), and the postoperative complication rate was 9.52% (4/42). The patency rate of the patients with successful operation was 97.5% (39/40) at 1 month, 87.5% (35/40) at 3 months, 72.5% (29/40) at 6 months, 52.5% (21/40) at 12 months, and 22.5% (9/40) at 24 months. The results of univariate analysis showed that postoperative smoking, poor control on blood glucose and blood pressure, residual stenosis, anastomotic stenosis and puncture point stenosis were independent risk factors affecting the patency time of internal fistula in elderly patients (all P<0.05). The results of multivariate Cox analysis showed that postoperative smoking, poor control on blood glucose and blood pressure, residual stenosis, anastomotic stenosis and puncture site stenosis were independent risk factors affecting the patency rate of postoperative internal fistula in elderly patients (all P<0.05).Conclusion Fogarty catheter thrombectomy combined with high-pressure balloon endovascular angioplasty has a high success rate, high short- and mid-term postoperative patency rate and fewer postoperative complications in the treatment of stenosis and thrombosis in autologous arteriovenous fistula in the elderly hemodialysis patients. Postoperative smoking, poor control on blood glucose or pressure, residual stenosis, anastomotic stenosis, and puncture point stenosis are important factors that affect the patency of internal fistula after surgery in these patients.