The tricuspid valve (TV) has traditionally been considered as a three leaflet valve—anterior, posterior, and septal. However, anatomical variations exist, ranging from 2 to 7 leaflet numbers. In a multinational retrospective study, only 54% of patients exhibited the classic three-leaflet configuration, whereas 39% had four functional leaflets. The anterior leaflet is typically the largest, while the septal leaflet is the smallest, positioned ≤10 mm apically from the interventricular septum. The posterior leaflet often contains multiple scallops. Accurate imaging of the TV requires multiple echocardiographic views. Mild physiologic pulmonic regurgitation (PR), is a common echocardiographic finding, present in approximately 75% of normal individuals. The pulmonary valve (PV) shares structural similarities with the aortic valve, possessing three cusps that are slightly thinner. Anatomically, the PV is positioned superior, anterior, and to the left of the aortic valve. Understanding the etiology of PR is crucial for determining its prognosis and guiding appropriate management strategies. In this chapter, we review the morphology, pathophysiology, and severity assessment of the Tricuspid and Pulmonary valve diseases.