The transradial approach is the main route in France to perform percutaneous coronary intervention, reaching nearly 60% of the cases in 2008. Its proven benefit in reducing bleeding complications and therefore its impact on morbidity and mortality are now well documented. However, a definite learning curve is necessary in relation with specifics challenges. Radial spasm and anatomical variations are the main reasons to explain failures encountered during its implementation. In order to increase success procedure, these difficulties and the ways to overcome them must be well-known. Finally, success rate is now comparable to the classical femoral approach.