Severe tricuspid valve regurgitation is an independent predictor of mortality in the general population and an important cause of heart failure. A surgical repair of the tricuspid valve is recommended in patients who need to undergo left-sided cardiac surgery. In patients who have isolated symptomatic and severe tricuspid regurgitation, surgical treatment is however associated with relatively high mortality, and the long-term benefits do not seem to overcome the medical therapy. For this reason, catheter-based interventions of the tricuspid valve have been developed. The “edge-to-edge” catheter repair of the tricuspid valve has demonstrated to be a feasible technique with very low complication rate and with good results in terms of quality-of-life improvement. Key for the success of the procedure is a careful patient selection and most importantly a good understanding of the mechanisms of valvular dysfunction. Transesophageal echocardiography plays a major role for the assessment of the tricuspid valve and most importantly for guiding the procedure in the cath-lab. The rationale of transcatheter tricuspid valve repair as well as the screening procedure and a step-by-step guiding of the intervention are described in the present chapter.