Abstract Funding Acknowledgements Type of funding sources: None. Introduction Tricuspid regurgitation is a prevalent and undertreated condition. Transcatheter edge-to-edge tricuspid valve repair (TTVR E2E) is an emergent option with promising procedural results in clinical trial and selected high-experienced centres. Tricuspid valve (TV) anatomy is highly variable. Whether different morphologies have a clinical or procedural impact over TTVR results are unclear. Purpose Our aim is to define the procedural, clinical and echocardiographic results of TTVR E2E technique in a "real-world" population according to TV anatomy. Methods We collected all TTVR E2E cases from 8 University Hospitals with large experience in SHDI from 2017 to 2022. It was a prospective inclusion, not randomized (real-world clinical practice). The TV morphology according to Hahn R. et al classification. Different devices (Mitraclip, Triclip & PASCAL) were employed. Clinical and echocardiographic follow-up were collected at 3 & 12 months after index procedure. We defined a combined clinical endpoint of all-cause death, HF admission and TV reintervention Results 147 consecutive patients were recruited (74 years old, 74% female). The baseline profile was HTN 68%, DM-2 21%, DLP 44%, atrial fibrillation 91%, previous CAD 19% and previous cardiac surgery 42%, COPD 19% and CKD 42%, STS mean 5,8 pts. The TR was ≥severe in all patients (vena contracta mean 12mm, gap size 7mm). According to the procedure, the most employed device was Triclip XT (70%, 1,7 devices/patient, 89% in anteroseptal commissure), with a procedural success of 99% and 93% without clinical complications. In our cohort, TV anatomy was conformed by 3 leaflets in 56% and 4 leaflets in 37% of cases. The morphology distribution was type I (50%), IIIB (31%), and a much lower frequent distribution of the other types (Figure 1). A significant TR reduction was accomplished in all TV morphologies without significant differences between them (Figure 2). The most frequent morphology (type I) versus the rest of morphologies, not revealed differences in terms of TR reduction or combined clinical endpoint. Restrictive septal leaflet presence (39%) is related with higher partial detachment prevalence (87 vs 17%, p 0,03). No other morphology parameters were related with procedural or clinical endpoint. Conclusions TV morphology was highly variable (50% of patients are non-Type I) being type I and IIIB the most prevalent. Posterior leaflet anatomy was the highest variable. Not differences were noted in TR reduction or clinical outcomes according to TV morphology. A restrictive septal leaflet were related with higher prevalence of partial detachment.