Common femoral artery (CFA) access, once standard, has been on the decline over the past two decades due to the advent and advantages of radial access for cardiac catheterization. The recognition that bleeding carried a similar risk as recurrent myocardial infarction (MI) in patients undergoing percutaneous coronary intervention (PCI) fueled the movement of bleeding avoidance strategies. Radial access has proven to be one of the most effective interventions in this regard. In addition, radial access is more cost effective and preferred by patients, compared to femoral access. However, even in a “radial first” cardiac catheterization lab, there are still cases where CFA access is chosen, based on patient-level factors, PCI complexity, or operator comfort. There are also an increasing number of large bore arterial catheter-based procedures being performed such as mechanical circulatory support and structural interventions, that require femoral access. All these trends require interventional operators to maintain a high level of skill in CFA access and closure. Fortunately, to keep up with the radialists, there have been several refinements in CFA access techniques.