Cardiac catheterization via the radial artery is associated with vascular complications, albeit less frequently than with the femoral approach. However, the management of these complications differs and is poorly described in the literature. We present our experience with vascular complications secondary to transradial access, with emphasis on their specific treatment. From January 2001 to October 2003 a total of 8159 cardiac catheterizations were performed, of which 3369 (41.3%) were done by radial artery approach. In 21 cases (0.06%) severe vascular hemorrhagic complications were observed (hematomas > 6 cm, n = 13; fistulas, n = 2; perforations, n = 5; pseudoaneurysm, n = 1). All patients were treated conservatively and none needed blood transfusions. A detailed description of the hemostasis techniques is provided.