Extracellular matrix (ECM) remodeling is a fundamental process in the pathogenesis of heart valve diseases. This review examines the role of ECM remodeling in valve disease progression, highlighting the molecular mechanisms, key regulatory factors, and clinical implications. We discuss how alterations in ECM composition and structure contribute to the development and progression of various heart valve diseases, including aortic stenosis, mitral regurgitation, and tricuspid valve disorders. The review also explores potential therapeutic strategies targeting ECM remodeling to mitigate valve disease progression.