Arteriovenous fistula of the kidney is a common complication of percutaneous needle biopsy with a reported incidence of as high as 15% in some series. Although a few cases eventually may develop hypertension, cardiomegaly or congestive heart failure, most heal spontaneously within 1-18 mo. Those which do not heal within this time are usually treated surgically and consequently there is little available information concerning the long-term conservative management of this problem. The subject of this report is a patient who has been followed medically for 10 yr and who, despite the persistance of a large fistula, remains in good health.