Mitral valve replacement utilizing autologous fascia lata has been undertaken in 65 patients with an operative mortality of 13.8%. All the survivors are greatly improved; a marked increase in exercise tolerance and a decrease in heart size are evident in all but one. Seven percent of the patients developed an apical systolic murmur after surgery; however, moderate mitral regurgitation was found in only one patient. Autologous fascia lata is fashioned into a three-leaflet valve attached to a rigid frame. It is nonthrombogenic and offers excellent hemodynamics. This initial experience has encouraged the authors to continue with this method of valve replacement.