This chapter discusses hemostatic strategies for patients undergoing distal radial access (DRA) for percutaneous cardiovascular procedures. Actually, DRA, specifically in the anatomical snuffbox, is established as a valid vascular access. The unique local anatomy of the anatomical snuffbox is reviewed, and various hemostasis methods are presented. These methods include traditional gauze and bandages, adjustable bands, conventional hemostasis devices, and specialized hemostasis devices, with a focus on their effectiveness and drawbacks. Duration of hemostasis and strategies for maintaining radial artery patency are also discussed. In addition, the “express hemostasis” protocol using vascular ultrasound for precise guidance is proposed for selected patients to reduce compression time and minimize radial artery occlusion. The role of ultrasound in conventional hemostasis protocols is highlighted as a means to effectively balance hemostasis and patency. The article concludes with recommendations for patient evaluation, including confirmation of hemostasis and assessment of radial artery patency prior to discharge, and emphasizes the importance of a quality control program to monitor access-related complications. This comprehensive review provides valuable insight into hemostatic techniques for DRA, with the potential to improve patient satisfaction and post-procedural care and expedite discharge.