Björk-Shiley tilting disc prosthesis was the first tilting disc prosthesis to be used worldwide on a large-scale basis. Herein, we report a case of a 67-year-old male presenting with severe prosthetic valvular dysfunction. He had undergone mitral valve replacement with Björk-Shiley valve at some other center in 1987. The surgical challenge was to replace that with an adequately sized prosthesis. To achieve that, we removed all the previously preserved posterior cusp and then reconstructed the sub-valvular apparatus. The patient had a smooth post-operative recovery. This case report highlights the longest reported survival of a Björk-Shiley mitral valve and specific challenges faced during such redo cases.