Objective <p>This study aimed to assess the effects of distal transradial access (dTRA) compared to conventional transradial access (cTRA) on procedure duration and radiation exposure among patients undergoing carotid artery stenting.</p> Methods <p>The study included 131 patients who underwent cerebrovascular interventional diagnosis and treatment in the Department of Cerebrovascular Diseases at Beijing Anzhen Hospital, Capital Medical University, from January 2022 to April 2024. Patients were categorized into dTRA and cTRA groups based on the puncture site. Clinical and laboratory data, operation duration, and the incidence of puncture-related complications and perioperative adverse events were recorded. Procedure duration and radiation exposure levels were then compared between the two groups.</p> Results <p>The dTRA group comprised 47 patients and the cTRA group comprised 84 patients. No statistically significant differences were observed between the groups in terms of risk factors and laboratory parameters (all <i>P</i> &gt; 0.05). Procedure-related comparisons between the dTRA and cTRA groups showed that the operation time for carotid artery stenting was (51.47 ± 10.51) minutes and (50.08 ± 11.37) minutes, respectively; the fluoroscopy time was (20.48 ± 5.55) minutes and (20.96 ± 9.24) minutes, respectively; and the radiation exposure dose was (573.60 ± 185.17) mGy and (567.09 ± 329.96) mGy, respectively. None of these differences were statistically significant (all <i>P</i> &gt; 0.05).</p> Conclusion <p>The results suggest that dTRA is comparable to cTRA in terms of procedure duration and radiation exposure during carotid artery stenting.</p>