Transcatheter aortic valve replacement (TAVR) has become the standard of care for patients with hemodynamically severe aortic stenosis who are symptomatic but deemed too high risk for surgery. Recent reports suggest that sex differences exist in outcomes following TAVR and in the diagnostic imaging evaluation of patients being considered for TAVR. In this review, the authors explore the differences between men and women in baseline characteristics and outcomes following TAVR, as well as sex differences in the imaging findings of severe aortic stenosis (AS) including the diagnostic challenges in the hemodynamic assessment of severe AS in elderly women, differences in aortic valvular calcification and in the associated myocardial response to severe AS. Additionally, sex differences in imaging findings as they relate to post-TAVR complications including coronary obstruction, annular rupture and prosthesis–patient mismatch are also discussed