Guide extension catheters and related methods are disclosed. A guide extension catheter can comprise an elongate tube member and a lumenless push member. The push member can be eccentrically coupled to the tube member for slidably positioning the tube member within and partially beyond a distal end of a guide catheter. At least a proximal end portion of the push member can include a cross-section defined by an arcuate first surface and an opposing second surface. The first surface can engage an inner wall surface of the guide catheter along an arc length, and the second surface can be spaced furthest from the first surface at its center point. The first surface can have the same or substantially the same radius of curvature as the guide catheter's inner wall surface, and the second surface can be flat or substantially flat. This configuration of the push member can provide an advantageous blend of stiffness and flexibility, as well as space conservation through the guide catheter.