Objective: The aim of the current study was to compare minimally invasive mitral valve surgery (MIMVS) with conventional mitral valve surgery via median sternotomy. Patients and methods: A total of 73 patients were recruited for a mitral valve surgery either minimally invasive (27 patients) or conventional open heart (46 patients) mitral valve surgery. Results: Patients in the MIMVS group reported less bleeding with fewer rates of transfusion and shorter hospital stay. Moreover, no differences were reported regarding major complications including stroke and myocardial infarction. Also, there was no difference in total hospital costs. Meanwhile, the MIMVS group presented a significant rise in the time of cardiopulmonary bypass, cross clamp and procedure. Six weeks follow up showed no significant differences in mortality. The causes of death in the MIMVS patient and the 2 patients in sternotomy group were non-cardiac, but due to infection by covid-19 which ended by respiratory failure. Conclusion: MIMVS could be more beneficial for mitral valve patients with consideration of inclusion criteria.