Background: The mitral valve is frequently affected by the complicated illness known as active infective endocarditis (IE), which has significant rates of mortality and morbidity. Objective: To evaluate early outcome after mitral valve replacement in adult patients with IE. Patients and methods: This descriptive prospective study was carried out at cardio thoracic Department at Suez Canal University Hospitals, where 30 patients who have infective endocarditis and underwent operative mitral valve replacement were included and were followed up for 3 months after surgery. Patients were clinically assessed and managed as per the ABC protocol, after stabilizing the patient. Postoperative evaluation was performed during their intensive care unit stay, hospital stay, and through first 3 months postoperatively. Results: A native infective endocarditis was present in 19 cases and a prosthetic infective endocarditis was in 11 cases. There were 9 cases with heart failure, 7 cases had risk of embolization, 9 cases had uncontrolled infection, and 5 cases had severe MR. There were 17 cases who needed inotropes for weaning from bypass. There was 1 case that had intraoperative mortality. Mean aortic cross clamp was 1.66 ±0.37. Mean intraoperative blood transfusion was 2.43±0.72. The mean hours of weaning from ventilator was 6.00 ±1.4 and of weaning from cardiac support was 25.84±16.5. Mean days of removal of med. drain was 3.46±0.50. Conclusion: There was increasing risk of 3 months mortality with prosthetic IE and staphylococcus infection. There was increasing risk of 3 months recurrence and CONS with staphylococcus infection. There was increasing risk of operative mortality with prosthetic IF and large valve vegetation.