Increasing the shear reinforcement ratio (ρ_w) can help meet architectural and structural requirements but often results in less reliable punching strength estimates from design codes. Nonlinear finite element analysis (NLFEA) has the potential to support a thorough assessment of the punching strength of slabs with shear studs, yet accurately modelling the interaction between concrete and transverse steel to capture the strength provided by shear rebars is challenging while using user-friendly software. This paper explores methodologies to assess the punching strength of slabs with double-headed studs with a commercial NLFEA program. Experimental tests were used to define the input parameters for the concrete’s nonlinear behaviour and to evaluate modelling approaches for shear studs, resulting in two strategies applied to slabs with varying ρ_w. NLFEA provided accurate punching strength estimates, consistently reproducing slabs’ rotations, crack patterns, and flexural strains. However, discrepancies in shear rebar strains highlight the challenges of using NLFEA to assess the response of slabs with shear reinforcement. Moreover, NLFE and experimental strengths were compared to estimates using the fib Model Code 2010 with levels of approximation (LoA) II, III, and IV, showing that, for the selected tests, increasing complexity in LoA IV did not consistently improve strength estimate accuracy.