The purpose of this study was to review the results of mitral valve replacement with mitral valve homograft, applying the method described by Acar, to determine if the method could be reproduced and was safe to use. Fourteen patients had replacement of the mitral valve with homograft. The diseased valve was excised and replaced with a cryopreserved homograft. The papillary muscles of the graft were attached to the papillary muscles of the patient in side-to-side fashion, using multiple stitches of fine monofilament suture. The annulus of the graft was attached to the patient annulus by continuous suture. The repair was supported by annuloplasty ring. All patients had intraoperative echocardiography. Patients were monitored clinically for up to 1.5 years. There were five men and nine women ranging in age from 16 to 70 years (mean = 43 years). Seven had rheumatic, six had degenerative, and one congenital morphology. Concomitant Maze III procedure was performed in three patients. All patients survived and are currently alive and in New York Heart Association functional class I. Thirteen patients have normal sinus rhythm. Only one patient has intermittent atrial fibrillation and is taking digoxin and warfarin. One patient had dehiscence of the recipient papillary muscle that required reoperation for mitral valve replacement with prosthesis. Three patients have moderate mitral valve regurgitation. Mitral valve replacement with homograft may be accomplished safely and reproducibly using the Acar method. Good short-term functional results and maintenance of normal sinus rhythm may be expected. Anticoagulant therapy should not be required.