The presence of concomitant aortic insufficiency (AI) and mitral regurgitation (MR) is common and may further accelerate cardiac dysfunction. However, there exists no United States regulatory approved transcatheter device for the treatment AI. The effectiveness of isolated transcatheter mitral therapy in this population is not well understood, thus we aimed to evaluate outcomes for patients with combined AI and MR in comparison to isolated MR that underwent mitral transcatheter edge-to-edge repair (m-TEER). Retrospective data were obtained from Northwell m-TEER registry. A total of 587 patients that underwent m-TEER at four high volume TAVR/TEER centers within the Northwell Health system were included. All patients had severe MR and were divided into two groups: Group 1 with ≥ 3+ AI (AI+) and the Group 2 with <3+ AI (AI-). Echocardiographic outcomes were evaluated at 1 month. Clinical outcomes were evaluated at one month and 1 year. The primary endpoint was death or re-hospitalization at 1 year. 587 patients were included in the study, 92 in the AI+ group. Baseline characteristics were similar in both groups. Approximately two-thirds of patients in the AI+ group demonstrated an improvement in AI severity after isolated mitral therapy. There was no difference in the primary outcome at 1 month or 1 year. There was also no significant difference in NYHA functional class at 1 month between groups. In conclusion, patients that underwent m-TEER with combined MR and AI (AI+) fared well in comparison to isolated mitral valve dysfunction (AI-), with no discernible differences in survival, NYHA class, or re-hospitalization rates at 1 month or 1 year. Hence, isolated m-TEER is a reasonable treatment approach in patients with a high surgical risk with combined AI and MR.