Background:  Recent justifications for minimally invasive techniques include the desire to reduce surgical trauma, enhance patient recovery, and lower costs without sacrificing the effectiveness of mitral valve repair or replacement. The objective of the current study is to ascertain whether minimally invasive mitral valve surgery using lower mini-sternotomies and mini-thoracotomies results in better postoperative outcomes than traditional surgery using a full sternotomy. Patients and methods: A total of 60 patients were included in this study, of which 30 cases were operated upon conventionally through full median sternotomy, 15 cases were operated upon through mini-sternotomy, and 15 cases were operated upon through right anterolateral mini-thoracotomy. Matched groups of patients were used. Results: Statistical analysis of the basic data of patients before operations showed no statistical significance between the groups. Minimally invasive mitral valve surgery was statistically associated with a significantly better outcome regarding ventilation time, chest tube drainage, blood transfusion and postoperative pain in comparison to conventional mitral valve surgery. These better results were not accompanied by significant increase in ICU stay, duration of inotropic support, postoperative complications, hospital stay and in-hospital mortality. On the other hand, intra-operative time parameters were shorter in conventional cases with statistical significance in total operative time when compared with minimally invasive cases. Mini-thoracotomy as an approach showed superior results when compared with the mini-sternotomy approach regarding chest tube drainage, and blood transfusion. However, mini-sternotomy cases showed less intra-operative time parameters, ventilation time, duration of inotropic support and postoperative pain with statistical significance in total operative time. Conclusion: Minimally invasive mitral valve surgery improved significantly the early outcome regarding ventilation time, chest tube drainage, blood transfusion and postoperative pain in comparison to conventional mitral valve surgery.