Stroke in patients with valvular heart disease undergoing transcatheter intervention is relatively rare but associated with significant morbidity and mortality. Risks vary according to the underlying valve disease and proposed procedure. While major improvements have been made in developing and understanding the technical factors associated with intra-and peri-procedural stroke, uncertainty exists regarding the optimal antithrombotic management strategy after transcatheter heart valve intervention and the utility of routine cerebral embolic protection. Further clinical studies are warranted to minimise these complications.