We report a case of 67 year-old female with a 48-year survival of a Starr–Edwards valve at mitral position. The patient underwent Starr–Edwards mitral valve replacement at age of 19 years for mitral stenosis secondary to severe rheumatic valve disease. The patient had experienced a progressive decline in her functional status with increasing dyspnoea on exertion over a two-week period to eventual development of severe shortness of breath at rest prior to hospitalisation. Transoesophageal echocardiogram revealed severe para-prosthetic and intravalvular mitral valve regurgitation. The patient underwent explantation of Starr–Edwards valve and replacement with a mechanical prosthesis. Our case details the longest reported survival of a Starr–Edwards prosthetic valve at mitral area.