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Aortic stenosis is a valve disorder that includes not only valve narrowing but also changes in the left ventricle and intracardiac hemodynamics. Older patients with aortic stenosis often have co-existing pathologic disorders, which influence the pathophysiology, symptom expression and prognosis. There is also increasing awareness that severe aortic stenosis could be associated with low transvalvular pressure gradient caused by a variety of mechanisms. Surgical and transcutaneous valve replacements are currently available interventions for patients with severe aortic stenosis. This article reviews the role of echocardiography in the comprehensive assessment of aortic stenosis, its severity and associated pathophysiologic abnormalities.