Percutaneous mitral valve repair (MVR) using MitraClip is an effective alternative treatment for patients with severe mitral valve insufficiency and high perioperative risk for surgery. Atrial fibrillation is frequent in patients needing MVR and some of these patients have contraindications for oral anticoagulation. Combining MitraClip implantation and occlusion of the left atrial appendage (LAA) may be of value in these patients with high thromboembolic risk. We report the first case of combined MitraClip procedure and percutaneous LAA closure in a single procedure.