Transcatheter edge-to-edge repair (TEER)with MitraClip (Abbot Structural, Santa Clara, California) is a well-established minimally invasive treatment option for patients with severe degenerative or moderate to severe functional mitral regurgitation. TEER is a complex procedure done under transesophageal echocardiography guidance, requiring a carefully placed transseptal puncture as well as navigating the device within the left atrium and mitral valve apparatus. Data from the National Cardiovascular Database Registry showed that increasing institutional case experience was associated with a lower rate of overall procedural complications, particularly the need for blood transfusion [ ]. However, the majority (~90%) of the TEER in this study were performed in the elective setting. In a previous study, urgent/emergent TEER (23.3% of the total U.S procedures between 2014 and 2017) was associated with higher risk of in-hospital death and other complications [ ]. Therefore, we conducted this study to examine the association of hospital procedural volume with outcomes of urgent/emergent TEER utilizing a large national database.