Mitral valve repair should have become thestandard therapy for mitral regurgitation (MR) due todegenerative disease, but unfortunately this is not thecase. Mitral valve replacement has been performedmore frequently mostly due to the lack of experiencewith repair techniques.Since its introduction, the techniques of mitralvalve repair have been subjected to many modificationsand improvements, leading to more predictable andreproducible methods. As there are many factorscontributing to MR, there cannot be a single solutionfor every case and an individual approach should beadopted according to the pathology and the surgeonshould be equipped with these techniques.