Despite risk of development of postprocedural aortic insufficiency, and restenosis at midterm, balloon valvuloplasty is an effective therapy for severe congenital aortic valve stenosis No consensus currently exists regarding optimal vascular approach for balloon dilatation in newborns with critical or severe aortic valve stenosis. Critical aortic valve stenosis in newborns must be treated promptly and effectively. Surgical therapy has been associated with significant rates of morbidity and mortality. Transcatheter therapy has significant advantages in this group of patients when compared with, surgical treatment. Percutaneous balloon dilatation is frequently performed as emergent therapy of valve ste-nosis, with various options for vascular approach. While umbilical artery and vein access has been tried in very few number of patients in the treat-ment of critical aortic valve stenosis and aortic coarctation. Umbilical artery, and vein access should be thought as an alternative to balloon dilatation of critical aortic stenosis. With available catheters this is a safe, simple, and effective procedure even in newborns weighing under 2.5 kg.