In this study of 165 elderly patients with severe symptomatic aortic valve stenosis treated with balloon valvuloplasty, long-term event-free and actuarial survival was poor regardless of symptoms at presentation and resembled the natural history of untreated aortic stenosis. Independent predictors of decreased event-free survival were younger age and low left ventricular ejection fraction. Selected patients, however, underwent subsequent aortic valve replacement with good results.