Transcatheter aortic valve replacement has revolutionized the treatment landscape of severe aortic stenosis, especially in elderly or high-risk surgical patients. Once reserved for those deemed inoperable, TAVR is now an established option across all surgical risk categories, supported by pivotal trials such as PARTNER, SURTAVI, and Evolut. Advances in device design, preprocedural imaging, and delivery systems have significantly improved procedural safety and outcomes. This chapter outlines the evolution of TAVR from balloon valvuloplasty to contemporary transcatheter platforms, including balloon-expandable and self-expanding valves. Critical anatomical considerations—such as annulus sizing, coronary ostia height, valve morphology, and vascular access—are examined as part of preprocedural planning. Emphasis is placed on individualized patient selection using guideline-directed risk stratification, Heart Team assessment, and multimodal imaging. Procedural techniques, alternative access routes, and adjunctive strategies like cerebral protection and antithrombotic therapy are discussed. Furthermore, the expanding indications of TAVR—including use in low-risk patients, bicuspid aortic valve disease, valve-in-valve procedures, and frail elderly populations—are reviewed. While short- and mid-term outcomes are favorable, long-term durability and coronary reaccess remain areas of active investigation. Ultimately, TAVR represents a paradigm shift toward minimally invasive, patient-centered management of valvular heart disease.