The creation of the Palmar Arch Classification was intended to guide the operators especially dealing with transradial/ transulnar cardiac catheterization, haemodialysis, radial artery harvesting for bypass grafting or vascular surgeries of upper limb. Till date, most of the studies incorporating palmar arches were done on cadavers. These studies provide us the various anatomical variations of hand circulation, but not the physiological significance of this important circulation. This study was the pioneer work on angiographic assessment of palmar circulation in human hands. This work got recognized at distinguished American College of Cardiology Conference, Washington DC, 2014 and later got published in prestigious vascular journal. This book was intended to describe all the untouched aspects of vascular anatomy of hand and forearm with appropriate images and illustrations. This book is especially suited for clinicians and operators dealing with complex anatomy of hand and forearm circulation.