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The first case of carotid stenting using the ulnar artery access ever done in The UAE, The Arabian Gulf Region and The MENA area. An 84 y/o male non-smoker, h/o HTN, hyperlipidemia and recurrent stroke. He had a NSTEMI 4 month ago. Coronary angio and PCI to LAD was done at that time using R femoral access. Carotid doppler showed bilateral severe ICA stenoses. LICA stenting was done 3 weeks ago using R radial access. •He was admitted for elective RICA stenting. Due to the bad experience with femoral access for his coronary angio and PCI (He developed groin hematoma), the patient insisted on getting his RICA stenting from the hand access. His R radial pulse was present, but it was weak. To avoid the risk of radial artery occlusion we decided to do the procedure from the right ulnar access.