Transcatheter aortic valve replacement (TAVR) has become an established treatment for severe aortic stenosis with growing indications to include patients at all levels of surgical risk. Despite advances in patient selection, operator skills, and valve technology, the procedure still carries a multitude of significant complications. In an editorial to a report from the PARTNER 2 trial on the effects of short-term complications on mortality and quality of life, Grube and Sinning coined the term “big five” to these major complications that strongly affect outcome. Amongst these are cerebrovascular events, complete atrio-ventricular blocks mandating pacemaker implantation, paravalvular leaks, acute kidney injury and vascular complications (VCs). These complications are associated with increased mortality, prolonged hospitalization and increased procedural costs. Thus, a continuous effort is made to further elucidate the mechanisms underlying these events, prevent them whenever possible, and treat them with vigilance to improve TAVR outcomes.