Objective: To evaluate the short and mid-term results of mitral valve repair by “edge-to-edge” technique in elderly patients with isolated commissural prolapse. Methods: Between Apr 2012 and Apr 2015, 32 consecutively elderly patients (≥65 years old) with isolated commissural prolapse underwent mitral valve repair in the unit, and the patients with coronary artery disease, rheumatic heart disease, infectious endocarditis or primary myocardiopathy were excluded. In the study, 20 male and 12 female were included, and the mean age was (68.4±2.8) years (range, 65~76 years). Eighteen patients were in New York Heart Association class Ⅱ, 12 patients in class Ⅲ, two patients in class Ⅳ. The technique used in the operations was surgical closure of the diseased commissure by edge-to-edge repair with 5-0 prolene suture, and mitral annuloplasty was performed routinely with annuloplasty ring in all patients. Results: All patients survived, and were followed up from 12 to 48 months. The patients had their cardiac function improved apparently (24 patients were in New York Heart Association class Ⅰ, 7 patients in class Ⅱ, 1 patients in class Ⅲ). There was no or trivial mitral valve regurgitation in 21 patients, mild regurgitation in 11, and moderate regurgitation or above in none. Left ventricular end diastolic volume (LVEDV) was reduced significantly, (158.2±28.6) mL preoperatively vs. (123.2±18.3) mL postoperatively (P<0.001). Conclusion: With “edge-to-edge” technique in elderly patients, mitral valve repair for commissural prolapse was simple, effective and reproducible. It could greatly decrease the operation time and obtain stable and excellent results.