We described a case of endoluminal stent placement for cervical internal carotid artery stenosis in which access was obtained via the proximal portion of the right radial artery. A 70-year-old man with a history of arteriosclerosis obliterans presented for endoluminal revascularization of a stenosed left internal carotid artery. The transfemoral approach was not possible because of severe atherosclerosis of the bilateral common iliac arteries. An approach was attempted via the right radial artery. After placement of a 6F short sheath in the proximal portion of the right radial artery, the guiding catheter was positioned in the left common carotid artery using the coaxial catheter system. Stenting was successfully performed under distal protection. This novel approach should be considered for endovascular procedures for which access to the carotid artery is limited.