Over the past 20 years, it is hard to imagine a more transformative therapy within cardiovascular medicine than transcatheter aortic valve replacement (TAVR). From the first case performed in April 2002 to the pivotal trials, overseas adoption, FDA approval, device iteration, technique evolution, and guideline recommendations, TAVR has become a standard and increasingly routine therapy for a growing proportion of patients with trileaflet aortic stenosis. Undeniably, the evolution of TAVR is a testament to partnerships between the various members of multidisciplinary teams, carefully designed and executed clinical trials, genuine critical appraisal, and steadfast drive to improve technology, procedural performance, and patient outcomes.