Objectives: Tunnelled-cuffed catheter (TCC) is the recommended choice of vascular access in patients needing haemodialysis for more than 2 weeks while waiting for permanent dialysis access. Even though the internal jugular vein (IJV) is the recommended site of insertion, many patients have exhausted or difficult vascular access; necessitating catheterization over the femoral vein (FV). Our study aim to look into the catheter-related blood stream infection (CRBSI) rate, bleeding, and thrombosis porportion of FV-TCC compare to IJV-TCC. Methods: We retrospectively looked into the outcome of all TCC inserted in the University of Malaya Medical Centre, Malaysia from 1/1/2016 to 31/12/2021. There were 626 catheters inserted in 363 patients. Each catheter was followed up until it was removed or until the end of this study.  Results: 389 FV-TCC and 237 IJV-TCC made up a total of 98727 catheter days. The most common cause of TCC removal was catheter thrombosis (25.2%), which was significantly associated with FV-TCC (p=0.005). Immediate bleeding after catheter insertion occurred in 6.1% of catheters while late bleeding (>24 hours) occurred in 8.3% of catheters. Bleeding risk was significantly higher in FV-TCC (p=0.034), lower baseline platelet (p=0.006) [median=233, IQR = 177, 292] and higher baseline INR (p=0.038) [median=1.2, IQR = 1.0, 1.2]. Overall CRBSI rate was low at 1.56/1000 catheter days. However, FV-TCC has a higher CRBSI rate at 2.08 whereas IJV-TCC reported a rate of 1.04. Cumulative infection-free survival was not significantly different for both types of TCC sites (p=0.061).  Conclusions: Internal jugular vein TCC remains the gold standard in patients requiring vascular access for more than two weeks as they are associated with less thrombosis and bleeding and a lower CRBSI rate. However, in a situation where there is no IJV access, FV access appears as a feasible site with an acceptable CRBSI rate compared to available literature of 1.3-5.5/1000 catheter-days.