Chronic kidney disease patients undergoing transcatheter aortic valve implantation are at high risk of post-procedural acute kidney injury. In order to minimize this risk, a meticulous procedural planning is needed, as well as a multidisciplinary team of interventionalists and imaging specialists.We present the case of an ultralow contrast transcatheter aortic valve implantation with an Acurate neo self-expandable prosthesis in a patient with advanced chronic kidney disease.