AimsWe compared the incidence of post‐procedural radial artery occlusion (RAO) and upper extremity dysfunction (UED), in patients undergoing conventional versus slender transradial (TRA) coronary procedures.Methods and resultsUED was assessed by the QuickDASH, before conventional (i.e., ≥6F) and slender (i.e., “virtual” 3F to 5F) procedures, after 2 weeks and 2 months. RAO was assessed by Duplex in patients with an abnormal reversed Barbeau test (RBT). A total of 212 patients were included, UED after 2 weeks was 12%, and after 2 months 7% (p = <.001). RAO occurred in 3%. Multivariate analysis showed an OR of 0.26 (CI0.08–0.84) for UED at 2 weeks (p = .03) in favor of slender TRA. In patients with RAO, UED did not improve at 2 months (2/5, 40%, p = .046).ConclusionsThe occurrence of UED after TRA procedures is temporary except for patients with RAO. Slender TRA seems able to reduce short term UED.