Transcatheter aortic valve implantation (TAVI) within failed bioprosthetic surgical aortic valves (SAVs) (valve-in-valve (VIV) TAVI) is expected to grow significantly because, in the last decade, bioprosthetic valves have been increasingly implanted instead of mechanical valves, even in young patients. These devices are prone to degeneration and failure. Although less invasive than surgical reoperation, challenges of valve-in-valve treatment include higher rates of malposition, prosthesis–patient mismatch (PPM), and coronary obstruction. Thus, optimal patient selection and preprocedural planning is of utmost importance to minimize the risk of these complications.