In recent years, transradial access (TRA) has spurred interest in the neurointerventional field, and distal radial access (DRA) has emerged as an improvement over conventional TRA, offering enhanced safety and ergonomics. This chapter reviews the benefits, techniques, and challenges of using DRA in neurointerventional procedures. In particular, we address patient preparation, access techniques, and considerations for diagnostic angiography and neurointerventional procedures using DRA. While DRA mirrors conventional TRA in some aspects, its unique characteristics require adaptation and specialized techniques. Despite challenges, emerging literature supports the use of DRA in neurovascular interventions, indicating its potential as an effective and safe access route for the treatment of cerebrovascular disease.