Transcatheter aortic valve implantation (TAVI) is now a standard procedure for the treatment of symptomatic aortic valve stenosis. Complication rates have declined markedly from 5.5% to 2% over the last decade. This includes procedural complications such as device malpositioning, embolisation, coronary obstruction, annular/ aortic rupture, pericardial tamponade or severe paravalvular regurgitation needing surgery. The complications, although rare, are clinically challenging and can be fatal if not dealt with expediently by experienced teams. The surgical mortality for these cases is high and can be up to 45–65%. This chapter deals with the commonest and most lethal complications that can occur following TAVI and how best to deal with those in an emergency setting.