A very rare case of suicide by stab wound of a fistula for hemodialysis acc
ess in an elderly woman is reported. The incidence of suicide attempts in p
eople undergoing hemodialysis is well known. Nevertheless, suicide means do
not usually include stab wounds of the arteriovenous access. Various patte
rn differences between homicidal and suicidal stab wounds, characteristics
of suicide in the elderly, and approaches to the investigation of such case
s are briefly discussed.