Central vascular catheters are used to access the central vascular system in both acute and chronic uremic patients undergoing hemodialysis. Among different approaches, the internal jugular vein seems to have less adverse effects. We describe our long-term experience with a two-catheter system. Percutaneous jugular vein cannulation was performed using Medcomp silicone rubber catheters. The study included 108 patients undergoing hemodialysis. One- and 2-year survival was 93 and 91%, respectively; 36 died because of unrelated causes. Blood flow rate was 284 mL/min; venous pressure at 1 year was 90 mm Hg. Complications included accidental withdrawal (6), dysfunction (4), catheter clotting (11), mediastinal hematoma (2), pneumothorax (1), and sepsis (7). Good long-term survival and a low complication rate make this system a safe and reliable method of access for long-term hemodialysis.