Radial access has gained prominence in various cardiovascular interventions, extending beyond coronary artery procedures to peripheral vascular interventions, neurointerventions, and selected structural heart disease procedures. In particular, distal radial access balloon aortic valvuloplasty (drBAV) has emerged as an innovative technique for the treatment of aortic stenosis, providing a less complex alternative to transcatheter aortic valve replacement (TAVR) and surgical valve replacement. The procedure has demonstrated high reproducibility and a low incidence of complications, with a large multicenter registry reporting favorable outcomes. This chapter provides a detailed step-by-step guide to performing drBAV, including all the necessary equipment and potential complications. With a focus on minimizing vascular complications, drBAV offers a promising approach to improving patient outcomes and quality of life, especially for those deemed ineligible for TAVR due to futility. Further research is needed to confirm its long-term efficacy and safety, but current evidence supports its viability as an alternative therapeutic option for patients with aortic stenosis.