Background: Conventional transradial approach (cTRA) gained sound acceptance as an alternative to transfemoral approach (TFA). However, it still having numerous pitfalls as hematoma, spasm and radial artery occlusion. Distal transradial artery access (dTRA) through the anatomical snuffbox emerged as a refined approach to overcome TRA drawbacks. Objectives: To evaluate the feasibility and safety of dTRA for coronary angiography (CAG) and percutaneous coronary intervention (PCI) compared with the cTRA. Patients and Methods: From February to December 2019, we enrolled 100 consecutive patients who were eligible for CAG plus/minus PCI. The patients were randomized to get their procedure from cTRA (Group I= 50 patients) or from dTRA (Group II= 50 patients). The demographic, technical and post-procedural data were recorded. Results: In the group II, male gender was predominant (p=0.041). cTRA group was associated with significantly shorter cannulation time (p= 0.025). The total procedure time was shorter in dTRA, However, it didn't reach statistical significance (34.2 ±25.3 versus 25.8 ±19.7 minutes, p= 0.066). The procedure success (92% vs 90% respectively), amount of contrast and radiation exposure, was similar in both groups. The risk of complication events as radial artery spasm, hematoma, or radial artery occlusion were similar in both groups. Conclusions: Distal radial approach for coronary diagnostic or intervention procedures is a feasible alternative to conventional radial route. dTRA is an attractive access with potential advantages of saving the proximal radial utilization as a graft for bypass surgery or future arteriovenous fistula creation for hemodialysis.