Distal radial access (DRA) is an emerging and advantageous approach to catheterization procedures that offers a transition from conventional transradial access (TRA). In fact, DRA seamlessly adapts to experienced TRA operators, making the conversion easy. Notably, left DRA mirrors the ergonomic benefits of femoral access, adding to its appeal as a primary access method that improves patient comfort and reduces complications. Effective DRA begins with a comprehensive assessment of the radial artery using a combination of palpation and ultrasound to determine site suitability and minimize complications such as arterial spasm or occlusion. Proper arm and hand positioning is essential, with the “just out of the snuffbox” site emerging as the preferred choice, facilitating puncture and subsequent compression. The choice of puncture site has a significant impact on the success and safety of the procedure and requires a tailored approach based on patient anatomy and operator skill. The procedure itself includes skin preparation, local anesthesia, and puncture techniques. This chapter illustrates how the success of DRA depends on meticulous method, operator skill, and appropriate patient selection. Anatomical awareness, precise positioning, appropriate choice of equipment, and post-sheath administration of spasmolytic agents all contribute to the favorable outcome of DRA procedures.