The results of mitral valve repair for structural disease are durable and are generally accepted to be superior to mitral valve replacement. Following the early pioneering work of Carpentier, most advances in mitral repair have involved performing the same repair through ever smaller incisions in hopes of minimizing tissue trauma. Mitral repair is now possible thru port access with videoscopic and robotic assistance. Transcatheter repair techniques are now being investigated and offer the possibility of mitral repair without the utilization of cardiopulmonary bypass.