BACKGROUND Transcatheter aortic valve implantation (TAVR) is a well-established treatment for symptomatic patients with aortic ste nosis. Yet the impact of sex differences and public vs private proce dural setting on TAVR outcomes remain uncertain. METHODS The RIBAC-NT (Brazilian Registry for Evaluation of Transcatheter Aortic Valve Replacement Outcomes) dataset included 3,194 TAVR patients from 2009 to 2021. This retrospective analysis explored disparities in baseline characteristics and procedural and in hospital outcomes, stratifying patients by sex and procedural setting. Temporal trends were also investigated. RESULTS We included 1,551 (49%) female and 1,643 (51%) male pa tients. Women were older (83 years (78-87 years) vs 81 years [75-85 years); P<0.01) but had a lower prevalence of diabetes mellitus (30.2% vs 36.3%; P<0.01) and coronary artery disease (39.0% vs 52.2%; P < 0.01). However, women had a 3-fold higher tisk of life- threatening bleeding (6.1% vs 2.4% P < 0.01). Women presented higher procedural and in-hospital mortality rates (4.4% vs 2.5% and 7.7% vs 4.5%; all P < 0.01, respectively). Over time, mortality rates decreased more in women than in men in both public and private centers. Public hospitals presented -2-fold higher procedural mor- tality rate compared with private settings (5.0% vs 2.7%; P<0.01). CONCLUSION Women had higher procedural and in-hospital mortal- ity rates after TAVR as compared with men, while facing higher life. threatening bleeding and adverse events rates. Public hospitals exhibited higher mortality rates than private centers. In recent years, women experienced more significant reductions in mortality rates in both settings.