Brachial artery catheterization via cutdown and a direct needle puncture was evaluated in 369 patients undergoing arteriography at the authors' medical center from January, 1970, to March, 1988. The indications for retrograde brachial arteriography were absence of palpable femoral pulses, failure of a femoral approach, previous aortic bypass surgery, and/or aneurysms of the ab dominal aorta. The technique and results are described. Two patients lost their radial pulse; 1 of them had thrombectomy and, one year later, developed an aneurysm at the site of the needle puncture. The authors conclude that catheter ization of the brachial artery through direct needle puncture is a safe procedure with good results.