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Tricuspid regurgitation (TR) is a highly prevalent and heterogeneous disease associated with poor outcomes, yet historically undertreated due to limited surgical options and under-recognition. The Tri-FR trial, an investigator-initiated, multicenter randomized controlled study, provides the first European RCT evidence that transcatheter edge-to-edge repair (T-TEER) on top of optimized medical therapy improves quality of life and functional status in elderly, comorbid patients with severe symptomatic TR. With rigorous imaging adjudication, real-world patient selection (mean age 78 years, 64% women, 95% AF), and pragmatic patient-centered endpoints, Tri-FR sets a benchmark for future studies. The trial highlights key challenges in imaging reproducibility, patient profiling, procedural timing, and residual TR grading, while its long-term follow-up will uniquely leverage both onsite reassessment and linkage to the French national health database (SNDS). Together with complementary RCTs and registries, Tri-FR reshapes the management paradigm for TR, emphasizing earlier referral, structured valve networks, and the need to balance repair versus replacement strategies. Still some data are missing for widespread adoption of transcatheter therapies. Recent ESC/EACTS guidelines IIa-A recommendation for T-TEER in severe isolated secondary TR is paving the way.