The ACURATE neo aortic valve system is a self-expanding transcatheter device that was granted CE mark in 2014 and since has 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 optimized positioning, results can be improved substantially. This review provides an overview of existing data and compiles a standardized manual of best practice for the implantation of this device based on both evidence and individual experience.