Acute coronary syndrome (ACS), manifested as either ST-elevation myocardial infarction (STEMI) or non-ST-elevation acute coronary syndrome (NSTE-ACS), is the most serious form of coronary artery disease. Coronary angiography is the gold standard for the diagnostic approach to ACS, and transradial access (TRA) has been established as a first-line option. Recently, an alternative approach has included catheterization of the distal part of the radial artery, mainly through the anatomical snuffbox. Distal radial access is emerging as a valid alternative to conventional TRA to further optimize hemostasis time and reduce radial artery occlusion. However, its comparative efficacy with TRA remains to be established in ACS patients, where delays in diagnosis and treatment may be associated with worse outcomes.