INTRODUCTION: Subclavian central line is routinely used for long term venous access for monitoring and therapeutic purposes since it is more comfortable to the patient. Ultrasound guidance can increase safety profile of the procedure. However the use of ultrasound for subclavian vein cannulation has technical difficulties because of its anatomical location under the clavicle.

TECHNIQUE: The subclavian vein is a continuation of the axillary vein as it crosses the first rib. Hence the subclavian vein can be accessed via the proximal part of axillary vein under the lateral third of clavicle. This axillary vein can be used as an access point for ultrasound guided subclavian vein cannulation with better safety profile and success.

CONCLUSION : The axillary vein approach to subclavian vein circumvents the technical difficulties of the traditional approach and provides the safety of ultrasound as well as the advantages of a subclavian central line.