Objective To analyze the clinical efficacy of valve-in-valve transcatheter mitral valve replacement in the treatment of degenerated bioprosthetic mitral valves. Methods The clinical data of patients who underwent transcatheter mitral valve replacement due to degenerated bioprosthetic mitral valves at the First Affiliated Hospital of Zhengzhou University from 2020 to 2023 were retrospectively analyzed, including baseline characteristics, surgical data, perioperative complications, and hemodynamic changes during the early postoperative and follow-up periods. Results A total of 31 patients were enrolled, including 7 males and 24 females with an average age of (66.57±9.32) years, and the average replacement time of surgical biological valves was (9.92±3.71) years. There were 7 cases transfemoral vene-atrial septal approach and 24 cases transapical approach. All patients showed significant improvement in cardiac function after operation, and the patients with New York Heart Association (NYHA) grade Ⅲ or Ⅳ and moderate and severe tricuspid valve regurgitation decreased. The peak flow velocity of mitral valve and the average transvalvular pressure gradient were decreased by echocardiography, and left ventricular ejection fraction had no significant change. One patient died of recurrent stroke on the 5th day after surgery, while the rest of the patients were discharged without complications such as cardiac death, all-cause death or outflow tract obstruction. During the median follow-up time of 12 months, no adverse events occurred and hemodynamics were stable. Conclusion The valve-in-valve transcatheter mitral valve replacement is safe and feasible for the treatment of patients with degenerated bioprosthetic mitral valves, demonstrating good hemodynamics and satisfactory short-term clinical outcomes.