The mitral valve is now one of the most operated pathologies. Department of cardiac surgery of the St. Ioasaf Belgorod Regional Clinic during the period 2015–2020 were executed average 485 operations per year. Of them 51–84 are operations on mitral valve. The mitral valve lesion etiologies are different: degenerative lesion, rheumatic valvulitis, secondary lesion to ischemic heart disease, infective endocarditis, hypertrophic cardiomyopathy. During the period 2015–2020 degenerative mitral valve lesion constituted 40,5 % – 61,7 % of cases. Of them the frequency of prosthesis implantation was decreased 50 % – 21,4 %. Frequency of mitral valve reconstructions increased from 50 % to 78,6 % during this period. In our practice reconstructive operations were applied in posterior leaflet pathologies (prolapse/rupture) when the need of PTFE neochords is minimal. In the cases of anterior leaflet pathology, we performed prosthesis implantation. For the valve reconstructions we used methods: isolated supporting ring implantation (27,3 % – 4 % cases), supporting ring implantation + posterior leaflet resection (quadrangular/triangular) (23,3 % – 36,4 % cases) and supporting ring implantation + posterior leaflet plication (10 % – 35,7 % cases). In this material the contevporary methods of mitral valve reconstruction were presented. Their advantages and disadvantages were discussed. We presented our set of methodologies and their distribution.