Minimally invasive mitral valve (MV) surgery was initially popularized using partial upper or lower hemisternotomies. Our preferred approach for rheumatic MV replacement is via a 5 cm right anterior minithoracotomy with video-assistance. This video illustrates our current technique of MV replacement using the Biocor bioprosthesis. 76 year old patient with severe rheumatic mitral stenosis underwent MV replacement with a 27 mm Biocor bioprosthesis and placement of Gortex neochord via a 5 cm right anterior minithoracotomy. Peripheral cannulation for cardiopulmonary bypass (CPB) and transthoracic crossclamp were used. Video-assistance was manipulated with the voice activated AESOP system. CPB and cross clamp times were 214 and 143 minutes respectively. There were no postoperative complications. The patient was extubated on postoperative day (POD) #1 and discharged home of POD #6. On follow-up, at 6 weeks, the patient had returned to normal daily activities and had no complains. Video-assisted minimally invasive MV replacement via a mini right thoracotomy offers great exposure to the MV and obviates the potential complications associated with sternotomy incisions.