The incidence of calcific aortic valve disease (CAVD) has increased dramatically as a result of the decline in rheumatic fever and the increase of the aging population, and by now CAVD has become the most common cardiac valve disease in the elderly in China. CAVD used to be thought as an irreversible passive process relating to valve degeneration and calcium accumulation. However, latest research has shown that CAVD is a complex active process, which involving vascular endothelial injury, lipid infiltration, chronic inflammation, matrix remodeling, cell differentiation, progressive bone formation, and neovascularization. Besides, genetic mutation also play a significant role in the process. Novel therapeutic target and technology such as transcatheter aortic valve implantation have been developed, which casts new lights on CAVD prevention and treatment. This review focused on the current understanding of the pathogenesis and future diagnosis/therapies of CAVD.