Transcatheter aortic valve replacement (TAVR) has emerged as the preferred treatment strategy for patients with severe, symptomatic aortic stenosis considered at prohibitive, high, intermediate risk for surgical aortic valve replacement. This manuscript has summarized various accesses of TAVR, imaging features and novel designs of TAVR. There are multiple avenues for delivery of TAVR devices, including the transfemoral route, transapical access, transaortic and other techniques. Transesophageal echocardiography and multidetector computed tomography are the major imaging means for TAVR. Innovative design in Evolut R 34 mm valve and Sapien 3 may reduce the amount of residual paravalvular regurgitation and offer increased success through transfemoral access. JenaValve technology has received extended Conformite Europeenne mark approval for the treatment of aortic regurgitation, which broadens the indication of TAVR. Finally we provide an outlook of the future of TAVR.