Over the past 5 years, more than 50 prospective and retrospective registries have been published on various aspects of distal radial access (DRA) for coronary angiography and intervention. In this chapter, we present a selection of relevant results from these real-world experiences that address the success rate, potential benefits, and complications of DRA. With a total of more than 10,000 coronary procedures via DRA documented and published in the registries presented here, this new puncture site can actually be regarded as feasible and safe. The cannulation success rate, which is perhaps the most important factor in establishing the DRA as a routine coronary access, is over 95% in the majority of studies, making it comparable to conventional transradial access. Several registries have looked at specific subgroups of patients (chronic total occlusions, acute coronary syndromes, ST-elevation myocardial infarction, end-stage renal disease, repeat puncture), and all have found DRA to be effective and safe.