Between January 1999 and August 2002, 13 patients with mitral regurgitation resulting from native valve endocarditis underwent surgery. The age of these patients was 54±13.8 years (range, 27 to 74 years); 8 patients were men. Five patients were categorized as New York Heart Association functional class III or IV. Endocarditis was active in 3 patients. Emergency or urgent surgery was required in 4 patients. Twelve patients underwent repair, and one had a valve replacement. Following the removal of all infected or nonviable tissue, a decision was made as to the possibility of repair. Repair was attemped in 13 patients and was successful in 12 patients. Most patients received ring annuloplasty with a Carpentier-Edward ring. Six patients had chordae ruptures, 5 patients had vegetations, and 2 patients had elongated chordae. Twelve patients were categorized as New York Heart Association functional class I, and one was categorized as class II at discharge. There were no hospital deaths. The mean follow-up of the 13 survivors was 24±14 months (range from 3 to 43 months). There were no late deaths, reoperations, recurrent endocarditis, thromboembolic events, or other valve-related morbidities. We conclude that mitral valve repair is an effective treatment for inective endocarditis with mitral regurgitation.