Carcinoid cardiac disease is a common complication of metastatic carcinoid tumours. It is characterized by tricuspid regurgitation and pulmonary stenosis. A 68 years old woman with a metastatic carcinoid tumour was admitted to hospital for congestive cardiac failure secondary to severe tricuspid regurgitation. Typical carcinoid lesions of the tricuspid and pulmonary valves were observed at echocardiography. A double valve replacement was performed with a favourable outcome. Postoperative echocardiography showed a significant improvement in right ventricular function. Surgical management of carcinoid valvular heart disease of NYHA Stage III patients is associated with an improved 2 years survival (from 8 to 40%) despite a high operative mortality (about 27%). Cardiac surgery remains the only hope of long-term survival with a spectacular improvement in symptoms.