Background: Symptomatic tricuspid regurgitation (TR) is associated with high mortality rates and HF-related hospitalization. Symptomatic therapy in elderly and very elderly patients remains weak in controlling severe TR. Patients with an increased risk of surgical repair of the TR seemed to benefit from transcatheter tricuspid valve repair procedures. Methods: Elderly patients with severe and symptomatic TR were presented and evaluated in the heart team. Patients with high surgical risks underwent transcatheter tricuspid valve repair procedures in our center. Post-procedural transthoracic echocardiography (TTE) technique was performed to determine the TR grade and exclude procedure-related complications. Results: Thirty-three consecutive patients older than 80 years (84.45 ±3.12, 14 men and 19 women, who received transcatheter TR repair between September 2021 and January 2022 were enrolled. The baseline characteristics are presented in table 1. Procedural success, defined as reducing the TR to grad I-II, was achieved in 97 % of the patients (3.79±0.65 vs. 1.55±0.56, p= 0.011). All patients improved in the New York Heart Association functional class (2.85±0.50 vs. 1.39±0.056 30 days after the intervention). No procedure-related death was registered. 87.9 % (n=29) survival rate was achieved three months after the intervention. No clip embolization was detected in 3 months of echocardiography control. Conclusions: Our results indicate that transcatheter tricuspid valve repair procedures are a safe and effective therapeutic option in elderly and very elderly patients with severe TR and high surgical risks. Therefore, this therapy should be considered despite age and comorbidities for effective symptomatic treatment in this cohort.