ABSTRACT Despite the well-known benefits of transradial access, critically-ill patients presenting with cardiogenic shock are usually submitted to coronary angiography and percutaneous coronary intervention via classic transfemoral access, mainly due to difficult puncture of radial artery in the setting of hemodynamic instability. We report a challenging case of anterior ST-segment elevation myocardial infarction, complicated by cardiogenic shock, requiring primary percutaneous coronary intervention of ostial left anterior descending artery with two-stents technique, safely and successfully performed via right distal transradial access.