In a comparative study, we examined the use of a peripherally implantable venous access system which does not require either central venous cannulation or radiological screening. We compared the complication rate in 85 patients receiving this system with that in 112 similar patients receiving Hickman lines. In addition, we examined the safety and cost implications of using a ward setting instead of full operating facilities for port insertion. There was a 10.7% incidence of early and 37.6% incidence of late complications in the group receiving Hickman lines compared with only 2.4% early complications and 10.6% late complications in those receiving peripherally implantable ports. There was no difference in complication rates between those patients who had the ports inserted in a ward side room compared with those who had their procedure performed in the operating theatre. We have demonstrated the ease and reliability of port insertion in the absence of screening radiology and we therefore suggest the peripheral port as a safe, cost-effective alternative to existing venous access systems.