AbstractTricuspid mitral valve is a rare entity, distinct from isolated clefts of the mitral leaflets. Echocardiographically, it manifests as the presence of three commissures, separate papillary muscles and concordant atrioventricular or ventriculoarterial connections. Three‐dimensional transesophageal echocardiography helps distinguish the three cusps from clefts. Herein, we present a case of tricuspid mitral valve that led to severe mitral regurgitation.