Background: Pressure recovery (PR) has been shown to occur distal to a stenotic aortic valve and its magnitude is primarily influenced by the diameter of the aortic root. It has only recently been appreciated that PRmay be clinically important in correctly classifying aortic stenosis (AS) severity. We sought to investigate the potential change in peak instantaneous pressure gradients (PSG) and indexed aortic valve area (AVAI) when accounting for pressure recovery. Methods:Retrospectivedatabase interrogationbetween 2007 and 2012 detected 82 consecutive patients diagnosed with severe native valve AS using current criteria (PSG≥ 64mmHg/peak transaortic velocity ≥4m/s, or AVAI≤ 0.6 cm/m2). Thirty patients were excluded due to left ventricular dysfunction (LVEF≤ 50%), atrial fibrillation, other severe valvular lesions, and another six due to suboptimal image quality, leaving 46 patients for analysis. The aortic root diameter was measured at the level of the sinus of Valsalva and incorporated into previously published formula. Statistical analysis was performed using Fisher’s exact test. Results: The mean pressure recovery gradient was 14± 5mmHg (range 6–25mmHg). The percentage of patients reclassified from severe to nonsevere AS using pressure recovery adjustedAVAIwas 17.4%and44%when using the PSG instead. A significantly higher proportion of patients were re-classified if BSA>2 (63%; P< 0.02). Conclusion:Depending on criteria used, accounting for pressure recovery appears tobe an important determinant to accurately classify AS. We suggest to routinely account for pressure recovery in the echo laboratory.