The keys to successful repeat mitral valve repair are careful selection of eligible patients and the use of high-quality surgical techniques. Regarding patient selection, patients with soft leaflet tissue, redundant rough-zone areas, and posterior mitral leaflet regions are good candidates for repeat repair. Autologous pericardial patch reinforcement for sutured dehiscence line, triangular resection for residual excess tissue, and sophisticated neo-chord reconstruction are high-quality techniques that increase the durability of repeat repair.