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background: Radial access is the object of increasing interest for interventional cardiologists, providing several advantages, including the reduced rates of major bleeding, which is related to increased risk of death and ischemic events. However, its role as an access technique in primary percutaneous coronary intervention (PCI) remains controversial due to the greater complexity of the procedure and possible delay in obtaining myocardial reperfusion, compared to femoral access. Methods: Retrospective study including consecutive patients with a diagnosis of ST-elevation acute myocardial infarction (STEMI) undergoing primary PCI by radial access. Clinical, angiographic and procedure characteristics were analyzed, as well as early and late follow-up outcomes. results: From October 2010 to February 2012, 61 patients underwent primary PCI by radial access. Mean age was 59 ± 11.1 years, 24.6% were female and 21.3% were diabetic. Door-to-balloon time was 126.1 ± 44.7 minutes, fluoroscopy time was 16.1 ± 9.5 minutes, angiographic success was achieved in 98.5%, with myocardial blush grades 2 and 3 in 77.4% and ST-segment elevation resolution > 50% at 90 minutes in 70.5% of the patients. Hospital mortality was 6.6% and the rate of major bleeding was 1.6%. In the late follow-up, clinical restenosis was observed in 7.2% and additional deaths in 3.5% of the patients. Conclusions: The use of radial access for primary PCI is safe and effective when performed at experienced centers and did not pres-