The main determinant of a successful cardiac catheterization and angioplasty/stent is safe vascular access and closure. Despite a rise in radial artery access, common femoral artery (CFA) access continues to play a pivotal role in cardiac catheterization for coronary angiography and large-bore access for transcatheter aortic valve replacement (TAVR). Techniques for access of CFA have undergone numerous changes and advances since their inception. The quest for safe access is to reduce complications of high puncture above the inferior epigastric artery, which may lead to retroperitoneal bleed, and low puncture, which may lead to hematoma.