Bicuspid aortic valve (BAV) disease, the most common congenital valvular anomaly, affects 0.5–2% of the population. Unlike tricuspid aortic valves, BAVs exhibit unique anatomical features, such as asymmetric cusps, elliptical annuli, and calcified raphes, posing significant challenges for transcatheter aortic valve implantation (TAVI). This chapter explores the technical challenges, imaging modalities, and procedural strategies for TAVI in BAV patients, emphasizing patient selection, device sizing, and implantation techniques. It reviews the role of computed tomography (CT) in pre-procedural planning and highlights the importance of personalized approaches to optimize outcomes. Despite advancements in imaging, devices, and procedural techniques, TAVI in BAV patients remains complex, requiring tailored strategies for successful interventions. The chapter also discusses the long-term outcomes and future directions for TAVI in younger and lower-risk populations with BAV-related aortic stenosis.