Dextrocardia is a cardiac positional anomaly in which the heart is located in right hemithorax with base-to-apex axis directed to the right and caudad. A number of congenital heart defects have been reported with dextrocardia, including VSD, PDA, ASD, TOF, pentalogy of Fallot, infundubular PS, transposition and pseudotruncus and total anomalous pulmonary venous return. We will share a patient with severe TR due to tricuspid valve commissural prolapse. A 42-year-old female patient was admitted to our clinic with the complaint of dyspnea. Transthoracic echocardiography revealed dextrocardia and severe TR consisting of two separate regurgitation jets. Contrast echocardiography performed due to dilatation of the coronary sinüs, did not show persistent left superior vena cava, and no right-to-left shunt was observed. Transesophageal echocardiography showed a prolapse in the commissure where the tricuspid anterior and septal leaflets meet, and a severe eccentric regurgitation jet with an area of vena contracta 0.75cm2 in the 3D MPR was observed. A moderate regurgitation jet was also seen from the coaptation line of all three leaflets. Commussural prolapse and regurgitation jet revealed in detail by 3D imaging. No significant pathology was detected in the other valves except mild insufficiency. Right heart catheterization and tricuspid valve surgery were planned for the patient with normal right heart functions. Although it is known that there are many congenital pathologies accompanying dextrocardia, we are happy to share our experience with you as the first case to report the coexistence of primary tricuspid valve disease and commusural prolapse with 3D detailed imaging.