Mitral regurgitation is the most prevalent valvular heart disease, with a poor prognosis that brings a heavy burden to population health and socio-economics. Transcatheter repair is a relatively mature technique for mitral regurgitation, but is strict in anatomical screening and the reduction of regurgitation is limited. With the advance in techniques and technology, transcatheter replacement has become an attractive treatment modality for mitral regurgitation in succession to transcatheter repair. At present, several replacement devices have initiated clinical trials to establish feasibility. Early data has shown that transcatheter replacement for mitral regurgitation is safe and effective, which needs to be confirmed with larger population and longer follow-up. Besides, some technical challenges remain to be addressed, in order to increase accessibility of this innovative technology.