This short article aims to discuss the potential complications of transradial procedures and to set out approaches to minimising or avoiding them. Complications may relate to the operator, the patient, the equipment used or the nature of the procedure. Complications can simply be defined as minor (non-life-threatening, reversible, unlikely to extend hospital stay) or major (life-threatening, likely to cause permanent damage or to extend hospital stay). The complications of transradial procedures are rarely major and very rarely life-threatening – a major benefit of the radial approach. The potential complications can be divided into: neuro-vascular complications, spasm, vasovagal reactions and reflex ST segment changes. artery have been reported following transradial procedures. These include dissection, haematoma, perforation, bleeding, pseudo-aneurysm formation, arteriovenous fistula and even ischaemic con-tracture involving the hand. Most of these complications are minor, but they can result in access or procedural failure. Major vascular complications are very rare, occurring in only 0.06% of a recent series of 5,354 consecutive transradial procedures. Localised radial occlu-sion, which causes no untoward ischaemia, occurs in up to 5% of patients, but half of these occlusions recanalise within weeks. Spasm This is the most common complication of transradial procedures, and can vary from a minor event to a major painful stimulus ending the procedure.