We present a modified bileaflet preserving mitral valve replacement technique to eliminate left ventricular outflow tract obstruction and larger size prosthesis implantation. Mitral anterior leaflet was incised from the middle of leaflet to mitral annulus. Pletgetted sutures were firstly bitten from mitral annulus and then passed from the bottom to the tip of anterior leaflet. These sutures were anchored to prosthesis. Bileaflet prosthesis was put down into the annulus and sutures were ligated on the strut of prosthesis. Posterior leaflet was also preserved. Excessive anterior leaflet tissue was attached to left atrium wall by deeply bitten sutures.