Valvular disease continues to be an important cause of morbidity and mortality across the globe with an increasing number of elderly patients affected by degenerative valvular diseases. Mitral valve disease is the most common of the valvular heart disorders, particularly in ageing populations, with a prevalence of more than 10% in people aged older than 75 years. Mitral regurgitation (MR) is divided into either primary (or organic) or secondary (or functional) MR. It is necessary to distinguish primary from secondary MR because these diseases differ not only by their cause, but also by their prognosis and management. Mitral stenosis is usually due to rheumatic disease, but annular calcification might cause obstruction in mitral valve, particularly in the elderly population. Because of the accompanying risk factors and comorbidities with the increasing age, surgical interventions have been replaced by catheter based alternative treatment options.