We learned from NASA's Kepler mission that small inner planets are common around Sun-like stars (50–100%). Separately, ground-based radial velocity (RV) surveys have shown that long-period gas giants are somewhat rare (~16%). To find the conditional occurrence of distant giants in systems with a close-in small planet, I conducted the Distant Giants Survey, a three-year RV search for giant planets in 47 systems with an inner transiting planet. I detected six giant planets, incorporating partial orbit “trends” by combining RVs with HGCA astrometry. I accounted for missed planets with a rigorous target-by-target completeness correction procedure. I found that giants occur in ~30% of systems with an inner small planet, twice as often as they occur around a random GK star. I also found that giant planets with inner companions have lower eccentricities than average, and their inner planets likewise have shorter periods, potentially pointing to a history of dynamical interaction. Finally, I discuss Gaia DR4's potential to reveal 3D system architectures, further elucidating the relationship between distant giants and close-in small planets.