Aorto-right ventricular fistulae have been thoroughly documented as a rare but potentially serious complication of surgical aortic valve replacement. The risk factors and pathogenesis contributing to this complication with respect to transcatheter aortic valve replacement (TAVR), however, remain far less characterized. Here we describe a post-TAVR aortic root-to-right ventricular fistula with associated pseudoaneurysm requiring surgical aortic root replacement. Aortic root-to-right ventricular fistula (AoRoot-RV fistula) formation is a rare but serious complication of transcatheter aortic valve replacement (TAVR), for which both conservative medical management and percutaneous interventions have demonstrated safety and efficacy in previous case reports. With expansion of TAVR into low-risk patients and complex anatomies, early diagnosis and treatment of unique complications is necessary. Here we describe a post-TAVR AoRoot-RV fistula with associated pseudoaneurysm requiring surgical aortic root replacement (ARR).