The benefits of transradial access (TRA) for percutaneous coronary interventions, including a lower risk of complications compared to transfemoral access, extend to peripheral vascular interventions by eliminating the need for post-procedural compression and allowing immediate ambulation. However, radial artery occlusion (RAO) remains a concern, occurring in 1–10% of cases and being influenced by sheath size, duration of compression, and patient factors. To overcome these limitations, distal radial access (DRA) in the anatomical snuffbox or dorsal hand has emerged as a promising alternative to conventional TRA, even for peripheral vascular procedures. In particular, DRA offers relevant advantages such as a reduced risk of arterial occlusion and high-grade hematoma as well as shorter compression times. In addition, left DRA appears to be more ergonomic and patient- and operator-friendly for peripheral procedures. This chapter reviews several peripheral procedures, including carotid, subclavian, and iliac artery stenting, providing detailed technical descriptions and practical tips to optimize outcomes. Despite challenges such as the smaller diameter of the distal artery and a degree of learning curve, DRA represents a significant advancement in vascular intervention. Its integration into clinical practice has the potential to further improve outcomes and procedural efficiency across all vascular procedures.