Arterial access for coronary angiography is usually achieved by the use of direct arterial puncture or, less frequently, by arterial cutdown. We present the case of a 39-year-old woman in whom a patent ductus arteriosus was used to enter the arterial system for left ventriculography, aortography, and selective coronary angiography. To our knowledge, this is the 1st reported case of selective coronary angiography with use of a transvenous approach.