Successful aortic valve replacement in the setting of aortic stenosis leads to dramatic improvements of the patient’s clinical condition and wellbeing. Standard surgical aortic valve replacement is a relatively safe procedure in patients with low procedural predicted risk. Because of thoracotomy, cardiopulmonary bypass, aortotomy and difficult rehabilitation, the risk of possible complications, especially in the elderly, can be high. The treatment of symptomatic aortic stenosis in high risk patients has led to alternative pathways of treating symptomatic aortic stenosis. Balloon aortic valvuloplasty, as the first attempt of definite treatment of aortic stenosis, was not very successful because it yielded only short-term results. Research continued with balloon-expandable and self-expandable aortic valve prostheses that are deployed at the site of the native aortic valve using special applicators through the peripheral vessels. This procedure has its advantages and disadvantages compared to the conventional surgical procedure, but current results in selected high risk patients are comparable. With new knowledge, and improved technique and instruments, outcomes can be expected to improve in the future.