The use of distal radial access (DRA) in interventional cardiology and radiology is gaining momentum due to its potential advantages over conventional transradial access (TRA). DRA offers improved ergonomics for both patient and operator and, reduces rates of forearm radial artery occlusion (RAO). Moreover, DRA has several advantages that may be important in preserving hand function, a complex and vital component of daily life that is often overlooked in vascular access. The anatomical snuffbox is most commonly used for DRA, allowing for a distal puncture and reducing hematoma and bleeding, thereby minimizing the risk of hand dysfunction. This chapter reviews the mechanisms of hand dysfunction associated with vascular access procedures and highlights the safety and efficacy of DRA in preserving hand function. Potential risk factors for hand dysfunction are also discussed, as well as the various treatment modalities available for hand dysfunction.