Background A comparison of efficacy and safety between transradial and transfemoral approach for percutaneous coronary intervention (PCI) in bifurcations has not been done. This study evaluated feasibility of transradial PCI (TRI) and compared the immediate and followup results with transfemoral PCI (TFI) in bifurcations.Methods One hundred and thirty-four consecutive patients with bifurcations were treated with PCl in our hospital from April 2004 to October 2005. Of these, there were 60 patients (88 lesions) in TRI group and 74 patients (101 lesions) in TFI group. Bifurcations type was classified according to the Institut Cardiovasculaire Paris Sud Classification.Results TRI group had smaller stent diameter ((3.06±0.37) mm vs (3.18±0.35) mm, P=0.023) and postprocedural in-stent minimum lumen diameter ((2.62±0.37) mm vs (2.74±0.41) mm, P=0.029) than TFI, but there were not significant differences in in-stent subacute thrombosis rate (0% vs 1.0%, P=0.349), target lesion revascularization (TLR)(0% vs 1.0%, P=0.349) following procedure and thrombosis (2.3% vs 1.0%, P=0.482), in-stent restenosis (12.5% vs10.9%, P=0.731), in-segment restenosis (17.0% vs 14.9%, P=0.681), TLR (10.2% vs 13.9%, P=0.446) and TLR-free cumulative survival rate (89.8% vs 86.1%, P=0.787) at seven months followup. No death was reported in the two groups.Conclusion Transradial intervention is feasible and appears to be as effective and safe as transfemoral PCI in treatment of true bifurcational lesions.