The last 10 years have been a time of dynamic evolution in the diagnosis and treatment of aortic stenosis in elderly patients. The pathology of diseased aortic valves has been better defined. Improvements in cardiac catheterization and Doppler echocardiographic assessment have been introduced. The initial promise of balloon valvuloplasty and ultrasonic valvular debridement was short-lived. Operative results improved and the importance of associated coronary disease has been investigated. While many issues remain unresolved, the lessons of the last decade should improve our clinical success in the future.