The increasing use of transradial access for percutaneous coronary procedures has improved patient comfort and outcomes but raised concerns about some complications, including forearm radial artery occlusion and hematoma. Distal radial access (DRA) in the anatomical snuffbox or dorsum of the hand offers an avenue. While DRA has gained popularity and demonstrated safety in various procedures, challenges remain, particularly with radial artery spasms or specific anatomical variations. This chapter systematically classifies access-related complications after DRA and provides insights into the prevention and management of complications associated with DRA, emphasizing the evolving nature of vascular access that offers new opportunities for endovascular interventions.