Background: Mitral Valve Surgery (MVS) performed through a Standard Median Sternotomy can be particularly technically challenging and is known to carry a potential risk of injuries to patent coronary artery bypass grafts and vascular structures that lie directly substernally and can adhere to the sternum. Postoperative complications after cardiac surgery, particu-larly when occurring in combination, have a profound impact on long-term early, survival and postoperative deaths. Aim of Study: To evaluate the early outcomes of minimally invasive mitral valve surgery versus standard median sternoto-my technique in patients undergoing mitral valve surgery. Patients and Methods: A retrospective comparative study that is conducted on cases candidate minimally invasive mitral valve surgery versus standard median sternotomy technique. Results: This study was conducted on 40 patients; 18 of them (45%) having isolated mitral valve disease, 22 (55%) hav-ing mitral plus tricuspid valve disease. All the patients com-pleted the study. There was no mortality among the patients. The patients were classified into 2 groups: - Group A: minimally invasive group. This group includes 20 patients requiring mitral valve surgery, and was approached through right anterolateral minithoracotomy. - Group B: Sternotomy group. This group includes 20 patients requiring mitral valve surgery, and was approached through conventional median sternotomy. Conclusion: According to the findings in the current study, minimally invasive mitral valve surgery is a safe procedure, as-sociated with a low incidence of intraoperative complications and excellent postoperative outcomes. However, the cost-ef-fectiveness remains controversial. Therefore, additional multi-center studies are needed to make econometric analysis for any future evaluation of novel cardiovascular therapies.