The technology and indications for transcatheter aortic valve implantation (TAVI) have been continuously evolving for over a decade. We evaluated temporal trends in patient selection and clinical outcomes in our regional TAVI cohort. Patients who underwent TAVI between October 2011 and December 2019 in the Auckland Region were included. Patient characteristics, procedural details and clinical outcomes were obtained from electronic records. A total of 461 patients were studied (54.9% female, mean age 79.5±8.4 years). TAVI was performed for severe aortic stenosis in the majority of patients (84.6%), while off-label indications were severe aortic regurgitation (8.7%) and mixed aortic valve disease (6.7%). Valve-in-valve TAVI was performed in 43 patients (9.3%), at a median of 13 years after previous aortic valve replacement. The mean EuroSCORE II was 5.5±4.4%, and there has been a shift over time to treating patients with lower risk. New York Heart Association Functional Classes III and IV were present in 170 (36.9%) and 22 (4.8%) patients respectively. Based on 30-day mortality risk, patients were stratified into 3 groups; 210 (46%) had low-risk (EuroSCORE II <4%, 30-day mortality 0.5%), 185 (40%) intermediate-risk (EuroSCORE II between 4%-9%, 30-day mortality 1.6%) and 65 (14%) had high-risk (EuroSCORE II >9%, 30-day mortality 4.6%, p=0.058). Transfemoral TAVI was performed in 411 patients (89.4%), and tended towards lower 30-day mortality when compared to non-transfemoral TAVI (1.2% vs 4.1%, p=0.12). Temporal trends in our TAVI cohort include increased utilisation in lower risk patients, off-label indications, and treatment of bioprosthetic valve failure. 30-day mortality in our cohort is low, especially in transfemoral TAVI.