With the advance of radial access and ulnar access there has been an increased interest in performing right heart catheterization (RHC) and right-heart based procedures via antecubital venous access. Our purpose is to describe the venous anatomy of the upper extremities, technique, equipment, and cost for employing this approach. Reported also is the international experience based on publications assessing procedural success, complications, fluoroscopy time and radiation dose, access-site compression time, and time to ambulation. We conclude that antecubital-venous-access based RHC carries satisfactory success rates, requires a short learning curve, and is exceptionally safe even when performed with full anticoagulation. It is our hope that industry will provide us with even better tools to extend the practice of antecubital-venous-access based procedures and interventions.