A deflectable sheath for use in medical procedures in the vasculature is described. The sheath includes a handle supporting the sheath. Two pull wires run along opposite sides of the sheath to anchors at the deflectable distal end. The handle includes a rotatable member that moves a threaded member including wire guide in a back and forth translation. As the movement occurs, force is applied to either one or the other of the pull wires to cause deflection of distal end of the sheath in either and upwardly or a downwardly direction with respect to the longitudinal axis of the sheath.