To evaluate the efficacy and safety of ultrasound technology for infraclavicular brachial plexus block in chronic renal failure patients undergoing arterio-venous shunt operations. Material and methods Our study included 40 patients with fulfilled clinical criteria of chronic renal failure. All patients (32 RT and 8 LT sided) were subjected to infraclavicular block using ultrasound visualization with 7.5–10 MHz linear probe. The anesthetic mixture consisted of 20 ml lidocain hydrocarbonate 2% and 20 ml of plain bupivacaine 0.5%. Sensory block, motor block and supplementation rate were evaluated for the musculocutaneous, median, radial and ulnar nerves. Results Surgical anesthesia was achieved without supplementation in 38 patients (95%) and 2 patients needed supplementation with infiltration anesthesia (5%). No patient in the study needed general anesthesia. Duration of surgery, administration, onset and complete blocks in minutes were (165 ± 11.7, 11 ± 4.5, 4.5 ± 1.5 and 8.5 ± 3.4), respectively. No vascular injury was reported in this study. Conclusion We concluded that real-time ultrasound imaging during infraclavicular brachial plexus blocks can facilitate nerve localization, needle placement and provide high success rate. Also it improves safety for ICBPB.