Purpose: To determine and to compare reintervention rate and secondary patency of radiocephalic fistula (RCF) after intervention of the juxta-anastomotic stenosis between surgical and endovascular repair. Methodology: All RCF with intervention to the juxta-anastomotic stenosis from 1 January 2017 to 31 December 2020 were recruited. Demographic details, types of intervention either surgical revision (proximal turndown of the RCF) or endovascular repair and reintervention data were collected retrospectively from electronic medical records. Reintervention rate within a year and secondary patency of the RCF after intervention within two years were analysed using Kaplan-Meier analysis. Results: A total of 109 RCF with juxta-anastomotic stenosis intervention were included. Surgical revision comprised 32% (35/109) while 68% (74/109) had endovascular repair. Reintervention rates within a year were 12% and 62% in surgical and endovascular groups respectively. The two-year secondary patency rate of the RCF after surgical revision was significantly higher at 75% compared to 44% in the endovascular group with p=0.007. Conclusion: Surgical revision of the juxta-anastomotic stenosis yields higher secondary patency and requires less reintervention than endovascular repair.