Background Tricuspid regurgitation(TR) is a common manifestation of tricuspid valve(TV) disease, affecting 65-85% of the population. TR has been increasingly recognized to be associated with deleterious outcomes. Despite its significance, TR remains undertreated. We investigated the survival outcomes of surgery for isolated TR in a quaternary centre. Methods Retrospective data of 214 patients who had TV surgery from January2009 to December2020 at a quaternary hospital in Sydney was obtained. Group A (101 patients) describes patients who had low-moderate TR and no right ventricle dysfunction (RVD); Group B (74 patients) describes patients with severe TR and no RVD; Group C (39 patients) describes patients with severe TR and RVD. Results Mean age of all patients at time of index surgery was 64 ± 15 years, 101 were females and 113 males. The mean EuroSCORE II was 2.4 (1.2, 5.6), mean hospital length of stay was 18 ± 25 days and mean intensive care unit length of stay was 10 ± 27 days. The total mean follow-up time was 13 ± 26 months. There were 41 (19%) deaths post tricuspid valve surgery at a mean age of 71 ± 16 years old and a mean time of 29 ± 37 months post tricuspid valve surgery. Patients with severe TR and RVD (Group C) were at a higher risk of death (HR 3.07 (1.25-7.55);p=0.0192) compared to Group A and B. Other risk factors for death include pre-op creatinine > 150 (p=0.009), pre-op PVD (p=0.016), pre-op NYHA class 3 and above (p=0.005), pre-op thienopyrine (p=0.001) and pre-op pulmonary hypertension (p=0.004). Conclusion This is the largest series to date and showed that patients with severe TR and RVD are at a much higher risk of mortality than those without RVD post-surgery. Consideration of early operation on this subset of patients should be undertaken.