The ACURATE neo aortic valve system is a self-expanding transcatheter device that was granted CE mark in 2014 and has since been widely adopted in the treatment of patients with severe aortic stenosis. The ACURATE neo can be used in a wide clinical spectrum, but there are some specific indications and anatomies where this device is particularly suitable. Recently, it was shown that, with appropriate patient screening, size selection, and optimised positioning, results can be improved substantially. This review provides an overview of existing data and compiles a standardised manual of best practice for the implantation of this device based on both evidence and individual experience.