Background: We evaluated surgical outcomes of mitral valve repair for active infective endocarditis. Methods: Among 37 consecutive patients who underwent the surgical treatment for native mitral infective endocarditis between 1999 and 2008, valve repair was performed in 14 patients (37.8%) and valve replacement in 23 patients (62.2%) during antibiotic therapy. Eleven patients (78.6%) had more than grade 3 mitral regurgitation. Mitral valve repair was mainly performed using valvulopasty with ring annuloplasty. Mean follow-up period was 54.75짹31.52 months (range, 7-105 months). Patients were evaluated for clinical and echocardiographic outcome. Results: There were no in-hospital death and 2 (14.3%) late deaths. During follow-up period, reoperation was observed in 1patient (7.1%) because of late recurrent endocarditis. At 10 years, 12 patients (85.7%) were in good functional status (NYHA class ���-���) with no or trivial residual mitral valve lesion on echocardiography. Clinical and echocardiographic outcomes had no statistically significant difference, compared to patients with valve replacement. Overall survival at 5 and 10 years was 91짹55% and 82짹7%. Conclusions: Mitral valve repair in patients with active endocarditis offers good early to mid-term results with low rates of recurrence or reoperation.