The treatment of functional tricuspid insufficiency associated with rheumatic left sided valvular lesions continues to challenge surgeons throughout the world. Opinions vary as to how tricuspid insufficiency should be treated. The present choices are:1.To expect spontaneous regression after correction of left sided valvular lesions in cases of trivial and mild TR.2.To repair tricuspid valve. Three methods are described for tricuspid valve repair:a.Bicuspidization annuloplasty changing tricuspid valve from trileaflet valve to a bileaflet one.B.Semicircular annuloplasty: the most commonly used semicircular annuloplasty techniques are DeVega annuloplasty and segmental annuloplasty.C.Ring annuloplasty.3.To replace tricuspid valve. Mechanical prosthesis is associated with high incidence of thrombo-embolism in tricuspid position while biological prosthesis is associated with rapid structural valve degeneration especially in young patients.This study compares the results of bicuspidization and DeVega in the management of functional tricuspid insufficiency. The operations were done in 40 patients and included simultaneous correction of rheumatic left sided valvular lesions. Each operations was performed in 20 patients. Re-evaluation of these patients showed that both annuloplasty techniques gave comparable and good results in early postoperative period, as well as on follow up until three months postoperatively. Also both are simple, rapid provide pliable annuls, eliminates the insertion of foreign material and free from the risk of producing atrioventricular block.