Spine deformities have several associations with compromised cardiorespiratory function. Percutaneous coronary interventions rely on fluoroscopic anatomical landmarks to guide procedures, and distortion of the mediastinal soft tissue and skeletal anatomy in conditions like kyphoscoliosis can pose unique challenges for the interventional cardiologist. Here, we report a case of elderly kyphoscoliotic male patient with worsening angina, who underwent successful percutaneous coronary intervention via the radial route.