Vascular complications arising after coronary angiography (CA) and percutaneous coronary intervention (PCI) may be under-reported. Access site complications were studied after consecutive CA and PCI in the investigators' center (an urban university hospital) from October to December 2002. Three hundred eleven consecutive procedures (237 CA studies and 74 PCIs) were included, of which 309 (99%) involved femoral arterial access. Seventy percent of all arterial punctures were closed by manual pressure, 28% by C-pressure clamps, and 2% with closure devices. Femoral hematomas occurred in 22% and 41% of CA studies and PCIs, respectively. Hematoma >5 cm occurred in 6% and 11% of CA studies and PCIs, respectively. Nineteen patients (23%) with access site complications had prolonged hospital admission. Increased body mass index and hematoma development within the catheter laboratory were predictors of prolonged admission.