Severe aortic stenosis may go unrecognized, and therefore untreated, in the setting of a low gradient, even if all data point to the existence of a low-flow, low-gradient state and a severe degree of stenosis. In this interview, Mirvat Alasnag, MB, BCH, FACC; Patricia Pellikka, MD, FACC; and Matt Cavender, MD, MPH, FACC, discuss when low-flow, low-gradient aortic stenosis is considered severe. For 20+ insider interviews like these every month with CME/MOC credit, subscribe to ACCEL at www.ACC.org/ACCEL.