The aortic valve separates the left main pumping chamber of the heart (left ventricle) from the main artery supplying blood to all of the body (the aorta) and prevents backward flow of blood. If this valve develops abnormally and becomes narrowed (bicuspid valve), this creates high pressures on the left side of the heart. This obstruction of blood flow to the body from the left heart leads to shortness of breath, fatigue, chest pain and can result ultimately in left heart failure. Two current treatments exist for correcting the valve narrowing, surgical (open-chest/heart) and catheter-based (nonsurgical). Surgical correction involves valve replacement, whereas catheter-based treatment usually involves a balloon dilation of the narrowed valve to relieve the obstruction, balloon aortic valvuloplasty (BAV). Both are safe and effective ways of managing bicuspid aortic stenosis and both prevent the adverse effects described above. Although surgical correction is a more definitive treatment modality, BAV has a long-term durability and is the treatment of choice in patients presenting early.