BACKGROUND: Uterine artery embolization (UAE) is a procedure commonly used to control uterine bleeding or pain. While the procedure is traditionally performed through the transfemoral approach (TFA), the transradial approach (TRA) is another method. PURPOSE: To compare the effectiveness of the UAE using the TRA approach versus the TFA approach. MATERIAL AND METHODS: This non-blinded, randomized clinical trial was conducted at a tertiary hospital between 1 January 2019 and 30 June 2022. A total of 42 female patients with abnormal uterine bleeding and/or pelvic pain from uterine fibroids were randomly assigned to either the TRA group or the TFA group. Data collected included demographic information, procedural details, patient satisfaction, and radiation metrics. RESULTS: The TRA group had significantly lower numbers of microsphere vials used compared to the TFA group ( CONCLUSION: Although both approaches were effective for the UAE, the TRA approach may be a viable alternative to the TFA due to its higher success rate in achieving bilateral catheterization, lower radiation doses, and shorter procedural times.