Between January 1988 and June 1996, a total of 531 patients underwent reconstruction of the mitral valve for mitral regurgitation (MR) with or without mitral stenosis (MS). Of these patients, 423 (79.7%) were aged under 30 years. The cause of mitral regurgitation was rheumatic in 471 patients (88.7%). Combined lesion (MR + MS) was present in 296 cases (55.7%). Operative mortality rate was 5.1% (27 patients) and there were 11 late deaths. Ten patients have been reoperated on for residual MR. All surviving patients were followed up by physical examination and echocardiography; follow up was 93% complete. The actuarial survival rate at 84 months was 93.1% and event-free survival rate was 87.3%. We conclude that mitral valve repair in the young rheumatic population is feasible, the probability of reoperation is low, and the symptomatic relief is gratifying.