Conduction system pacing (CSP) aims to achieve physiological ventricular activation through direct stimulation of the His bundle or the left bundle branch and its fascicles, providing rapid and synchronous left-ventricular depolarization. Compared with conventional right-ventricular pacing, CSP implantation is technically more demanding, requiring detailed understanding of conduction system electrophysiology, accurate interpretation of intracardiac electrograms, and reliable confirmation of conduction system capture. Over recent years, dedicated implantation techniques and fluoroscopic and electrocardiographic landmarks have been developed to optimize lead positioning. Furthermore, a variety of tools, including guiding sheaths and both lumenless and stylet-driven leads from multiple manufacturers, are now available to facilitate safe and effective CSP implantation.