Is there still a debate about right radial artery (RRA) access versus left radial artery (LRA) access? A recent American Heart Association Update on Radial Artery Access and Best Practices states, “The choice between RRA versus LRA access is based on operator preference.” A large meta-analysis of 12 prospective, randomized clinical trials comparing RRA versus LRA access in 6450 patients found no difference in complications, including stroke, and little clinically meaningful difference in fluoroscopy time (5.9 ± 4.4 min RRA vs 5.3 ± 4.2 min LRA, P <0.001) and contrast used (84 ± 35 mL RRA vs 82 ± 34 mL LRA, p = 0.003) . There was a similar rate of cross-over (4.2 % RRA vs 4.1 % LRA) and total procedure time. So does it matter which radial artery is accessed? As with many things, the devil may be in the details. Is there any patient population where an operator should have a preference for the LRA as opposed to the RRA, especially a less experienced or lower-volume radial operator? Is there better success from the LRA in those patients with known risk factors for lower trans-radial artery access (TRA) success, i.e. the elderly, women, and short statured? In this issue of CRM , Dr. Jones et al. shed a little light on this question.