Surgical aortic valve replacement has been the gold standard for treatment of symptomatic aortic valve disease. However, the success of this approach depends on various patient- and situation-specific risk predictors; thus, the perioperative mortality can reach up to 50%. Percutaneous valve replacement might offer a new less invasive alternative. Since 2002, a balloon-expandable valve prosthesis is under evaluation in symptomatic high-risk patients with aortic valve stenosis. After modifications of both the implantation technique as well as the design of the prosthesis, procedural success rates of > 75% and adverse event rates of < 20% at 30-day follow-up have been reported. A new alternative to this approach is the self-expanding valve prosthesis. The recently reported First-in-Man Study demonstrated the feasibility of this technique. However, the strict inclusion criteria for both procedures limit the number of potential candidates. New devices are currently under development, which will allow for a broader use of percutaneous valve replacement in the near future.