Traumatic tricuspid valve insufficiency is a rare in vivo finding, especially in combination with other traumatic cardiac injuries like ventricular septal defect, myocardial infarction, and traumatic coronary fistula. Two-dimensional and, more recently, colorcoded Doppler echocardiography have gained importance for the diagnosis of tricuspid insufficiency. Patients with traumatic tricuspid insufficiency who survive the acute trauma, may remain asymptomatic for many years and even decades. If symptoms develop, tricuspid valve replacement appears feasible even after many years.