For patients with heart valve disease, valve repair and replacement continue to be the preferred treatment option over conservative management. These techniques have come a long way in the last decade or so, especially with the advent of minimally invasive surgical and interventional approaches. Some of these techniques are still immature, but some are widely and routinely used in the clinic, especially in some of the larger medical centers. The advent of new techniques has allowed cardiologists to treat more patients, especially those who were once considered unfit for surgery. 1, Aortic Valve Disease In the field of surgical treatment of aortic valve disease, two major new treatment trends have emerged over the past decade. First, there has been a global shift toward a greater preference for the use of bioprosthetic valves, again due to the excellent hemodynamic characteristics and durability of the new generation of bioprosthetic valves. Second, the small-incision, minimally invasive surgical approach has demonstrated the same safety and efficacy as the traditional standard median sternotomy, which has been further facilitated by seamless and implantable technologies. One of the most memorable advances in the field of interventional therapy was the first transcatheter aortic valve implantation (TAVI) performed by Kribill in 2002, which can be an effective treatment for elderly patients, those with comorbidities, and those who truly cannot tolerate surgery. Because it avoids the need for a median sternotomy, extracorporeal circulation, cardiac arrest, or even general anesthesia (in the case of transfemoral placement), TAVI is technically challenging even though it carries a high incidence of residual aortic regurgitation and pacemaker implantation. However, with the development of easier and more convenient valve implantation, further improvements in computer hardware, and the increasing experience of cardiac surgeons and interventionalists, TAVI has become a routine treatment and is a good option for high-risk and inoperable patients. Similarly, in the field of mitral valve surgery, doctors are increasingly focusing on minimally invasive treatments in order to minimize patient trauma. In experienced centers, mitral valve replacement and repair can be performed safely with minimally invasive surgery or robotic-assisted techniques. Mitral regurgitation repair has become a quality indicator in many medical centers. Valve reconstruction is a feasible and appropriate treatment for most patients with degenerative valve disease; however, the outcome of ischemic mitral regurgitation reconstruction and repair is often complicated. Because these patients often have a combination of progressive heart failure and mitral regurgitation, intervention may be a reasonable treatment option. Several devices that mimic key steps in surgical repair techniques have emerged. Studies have shown that the MitraClip provides symptomatic relief, but long-term efficacy needs to be further evaluated. The natural next step is transcatheter mitral valve replacement, and the first in vivo trials have been reported. Although the anatomical challenges of mitral valve replacement are much higher than those of aortic valve replacement, the absolute number of patients with high-risk mitral valve disease seems to make refinement of these devices imperative. 3, Tricuspid Valve Disease The tricuspid valve has long been neglected but has gained ample attention in the past decade. For many years, mild tricuspid insufficiency was thought to be reversible, or at least not to worsen, when other valves were treated. However, studies published in the last decade have shown that concomitant repair of the tricuspid valve improves the long-term prognosis, and therefore the current trend is to perform tricuspid valve reconstruction of enlarged tricuspid annulus even if regurgitation is minimal. Another surgical advance that has influenced clinical decision making is the introduction of the concept of transcatheter implantation of valves in failing bioprosthetic or orthopedic annuloplasty valves. This intravalvular inlay valve or intra-annular inlay valve option not only helps to avoid complex reoperations in high-risk patients, but also increases the use of bioprosthetic valves in the initial surgery. It is usually used in younger patients. Over the past decade, there has been an effort to minimize surgical trauma without compromising clinical prognosis and to make minimally invasive valve surgery routine for low-risk procedures. At the same time, the development of transcatheter valve implantation has further enriched the therapeutic options. The rapid advances in valve repair and replacement techniques over the past decade have been very encouraging, and we look forward to further developments in the future.