Of the 75 cardiac valves excised at surgery over a 2 year period, 54 were mitral valves. Using simple morphological criteria along with clinical data, the valves were assigned to 2 major groups, rheumatic and non-rheumatic. The group with rheumatic disease accounted for 90% of cases. Mitral stenosis, incompetence and combined stenosis with incompetence were encountered with equal frequency (38, 38 and 24%). Mitral insufficiency of rheumatic etiology, no longer considered to be a major problem in the west, continues to be frequent in India. An increased incidence of mitral regurgitation in young females is an important feature noticed in this series.