Choice of prosthetic valve during valve replacement in dialysis patients is still controversial. There is a known risk of early structural valve deterioration of bioprosthesis in dialysis patients, whereas mechanical prosthesis is associated with a higher risk of bleeding and thrombotic events. A 68-year-old dialysis-dependent woman, who had undergone bioprosthetic mitral valve replacement at the age of 66, was admitted to our hospital because of general malaise and hypotension during dialysis. Echocardiography revealed severe mitral stenosis and regurgitation due to restricted motion and dense calcification in prosthetic valve leaflets, which indicated early structural valve deterioration. Redo mitral valve replacement using a mechanical valve was performed, and the patient gradually recovered. However, she eventually died of intracranial hemorrhage three months after the surgery.