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OBJECTIVE: To determine the safety and success of transradial coronary angiography and angioplasty ina tertiary care hospital.METHODS: The feasibility and safety of routine transradial coronary angiography was assessedprospectively in 591 patients from March 2011 to March 2013 at Cath lab of cardiology department LadyReading Hospital Peshawar. All patients with normal Allen's test were included in study. Patients havingabnormal or modified Allen's test, on haemodialysis or had abnormal serum creatinine level were excludedfrom the study. If the rightradial approach was used in all cases. The main outcome measures were successrate and complications of transradial coronary angiography. The catheter selection was a 6FJL 3.5 for rightcoronary artery and 6FJR 4 catheter for left coronary artery. In 354(60 percent) cases, coronary angiographywas performed by using 6F JR4 for both coronary arteries.RESULTS: The mean age was 55 ±10.08 years with 437 (74%) males and 154 (26%) females.A total of 591coronary angiographies were perform though trans-radial route in the study period. Overall proceduresuccess rate was 95%(561 patients) for transradial coronary angiography, with mean procedure time of21.25 ± 5.25 minutes ,mean fluoroscopy time of 6 ± 3.15 minutes, and 90% of patients were discharged onthe same day. Only 2 patients had mild forearm haematoma, pain and spasm of radial artery occlusionoccurred in 20 (3.38%) study patients. Asymptomatic radial occlusion in 8(1.35%). The reason for failure oftransradial procedure included failed radial artery puncture (n=6), radial artery loop (n=2), tortuoussubclavian artery (n-3), failed catheterization of coronary arteries in 5 patients (2.53%) and severe radialartery spasm in 20(3.38%).CONCLUSION:Trans-radial artery cannulation is a safe and successful route for performance of coronaryprocedures.It can be used as an acceptable alternate to transfemoral.