Despite increasing adoption of the transradial approach for percutaneous coronary intervention (PCI) in clinical practice, the role of transradial intervention (TRI) in women remains a significant debate. We identified 1392 women from a consecutive cohort of patients undergoing PCI in China in 2010 and compared the efficacy and hospital costs between TRI and transfemoral intervention. An inverse probability weighting (IPW) method was used to control for potential bias. After IPW adjustment, patients receiving TRI were less likely to experience post-PCI bleeding (adjusted odds ratio [OR]: 0.46, 95% confidence interval [CI]: 0.30-0.71) and major adverse cardiac events (adjusted OR 0.35, 95% CI 0.19-0.63) and more likely to have shorter length of stay in hospital (1.2 days difference, 95% CI: 0.6-1.7). Moreover, TRI was associated with a cost saving of ¥ (Yuan Renminbi) 7474 (approximately US$1150, 95% CI: ¥2993-¥11 624). More than 70% of this saving was driven by lower PCI-related costs. In conclusion, the use of TRI in women was associated with more favorable outcomes and lower hospital costs.