Minimally invasive mitral valve surgery (MI-MVS) has been gaining momentum since its introduction in the mid-1990s. It is a complex procedure that requires collaboration and teamwork. The anesthetists play a major role in a MI-MVS and are a cornerstone for a successful program. Their role extends from the preoperative period, all through the surgical treatment process, till discharge planning. The authors would like to highlight, in this work, the contribution of the anesthetists to the MI-MVS program and the modifications they perform to their normal setup and practice to accommodate a minimally invasive approach.