Objective: To explore the effectiveness and safety of distal radial artery approach in neurointerventional diagnosis and treatment. Methods: Sixty patients who underwent neural intervention (selective cerebral angiography or stent implantation) in our hospital from July 2024 to February 2025 were selected as the study objects, and were divided into two groups according to random number method. The control group received conventional radial artery approach (n=30), and the study group received distal radial artery approach (n=30). The puncture conditions (puncture success rate, mean puncture time), pain and complications of the two groups were evaluated. Results: The successful rate of puncture in two groups (control group: 100.00%; Study group: 86.67%), the average puncture time (control group: 5.21±1.58min; Study group: 5.49±2.01min), there was no statistical difference (P > 0.05); Preoperative NRS scores of the two groups (study group: 0.65±0.34 points; The NRS score of the study group (4.11±2.17 points) was lower than that of the control group (5.66±2.09 points) (P < 0.05). Complication rate in both groups (study group: 13.33%; Control group: 10.00%) had no significant difference (P > 0.05); The total comfort level of the study group (73.33%) was higher than that of the control group (46.67%) (P < 0.05). Conclusion: The puncture success rate, puncture time and safety of the distal radial artery approach are similar to that of the conventional radial artery approach in neurointerventional diagnosis and treatment, but the distal radial artery approach can reduce the pain degree of patients and improve the comfort level of patients, and is worthy of clinical application.