Minimally invasive approaches to mitral valve surgery represent a significant advancement in cardiac surgery, offering potential benefits over traditional sternotomy. This abstract reviews the current landscape of minimally invasive mitral valve repair and replacement techniques, highlighting their advantages, limitations, and evolving role in patient care. Techniques such as right mini-thoracotomy, left mini-thoracotomy, and robotic-assisted approaches are explored, each presenting a unique surgical field and access strategy to the mitral valve. These techniques aim to reduce surgical trauma, leading to decreased postoperative pain, shorter hospital stays, faster recovery times, and improved cosmetic outcomes compared to conventional sternotomy.The choice of minimally invasive approach is tailored to individual patient characteristics and the specific mitral valve pathology. While minimally invasive repair remains the preferred approach when feasible, the suitability of minimally invasive replacement techniques is continuously being refined. Technological advancements, such as improved robotic platforms, smaller instruments, and enhanced imaging modalities, are crucial in expanding the applicability of these techniques to more complex cases. However, limitations persist. The restricted surgical field and limited maneuverability can pose challenges, potentially requiring conversion to sternotomy in some instances. Furthermore, the learning curve associated with these techniques necessitates specialized training and experience.Despite these limitations, the accumulating evidence suggests that appropriately selected patients undergoing minimally invasive mitral valve procedures experience comparable or superior clinical outcomes to those undergoing conventional surgery. Ongoing research focuses on identifying optimal patient selection criteria, improving surgical techniques, and developing novel technologies to further minimize invasiveness and enhance the safety and efficacy of these procedures. The future of minimally invasive mitral valve surgery likely lies in the continued refinement of existing techniques, the development of new approaches, and a more widespread adoption based on rigorous clinical evidence and patient-specific considerations.