The vascular access method in patients initiating dialysis significantly affects survival rates. This study aimed to evaluate the impact of early arteriovenous fistula (AVF) formation on survival by comparing six-month mortality rates between patients using a temporary catheter and those with a preformed arteriovenous fistula. A retrospective analysis was conducted on 2,758 patients aged 70 years or older who started hemodialysis. The subjects were classified into two groups: (1) the Temporary Catheter group (arteriovenous fistula not preformed) and (2) the Preformed Arteriovenous Fistula group (arteriovenous fistula preformed). The six-month mortality rate after dialysis initiation was compared between the two groups. Statistical analysis was performed using the chi-square test. The six-month mortality rate was 19.96% in the Temporary Catheter group and 5.95% in the Preformed Arteriovenous Fistula group, showing a significantly higher mortality rate in the Temporary Catheter group (Chi-square = 55.29, p < 0.001). Additionally, the mortality rate in the Temporary Catheter group was approximately 3.35 times higher than that in the Preformed Arteriovenous Fistula group. Patients with a preformed arteriovenous fistula had a significantly lower six-month mortality rate. This finding suggests that early arteriovenous fistula formation may improve survival rates in patients initiating hemodialysis.