This idea is dedicated to the creation of a System for Functionality Assessment of Arteriovenous Fistula (AVF) or Graft (AVG) for Hemodialysis. It addresses the critical need for monitoring AVF/AVG functionality over time, introducing a novel approach utilizing piezoelectric sensors to analyze vascular wall vibrations. The research methodology involves the feasibility and applicability assessment of the proposed system, selecting suitable sensors, and evaluating their functionality on AVF/AVG patients, retrospective and prospective analyses, involving regular measurements to track fistula evolution and functionality and an in-depth analysis of the collected data, utilizing advanced methods to explore correlations between ultrasound images indicating stenosis and sensor signals. Anticipated outcomes of this research include the development of a monitoring system capable of contributing in early stenosis detection, providing valuable insights for improving the clinical outline of patients’ vascular access, optimizing treatment strategies, and enhancing cost-effectiveness in healthcare. This implementation of this idea contributes to advancing the understanding of AVF/AVG functionality, bridging gaps in current monitoring practices, and offering potential innovations for improved hemodialysis care.