Aim. To assess the effectiveness of suture annuloplasty in correction of mitral insufficiency of various etiologies. Material and methods. The study included 389 patients with mitral insufficiency who underwent suture annuloplasty of the mitral valve (MV) under cardiopulmonary bypass and isothermal blood cardioplegia. Conventionally, these patients were divided into two groups: 180 people from the group of ischemic mitral regurgitation, 209 — from the group of «nonischemic» etiology. All patients had mitral regurgitation due to marked dilatation of the MV annulus. Results. Suture annuloplasty allowed to reduce significantly the diameter of the fibrous ring in patients with ischemic and non-ischemic mitral regurgitation. In remote period diameter of the fibrous ring was not significantly increased in any groups, that indicates an effectiveness of repair and stable result. 5-year freedom from recurrent mitral regurgitation in patients with initially severe ischemic mitral insufficiency was 77.5%. 8-year Kaplan—Meier freedom from recurrence in patients with «non-ischemic» mitral insufficiency was 93%. The cause of recurrent MR in these patients was the progression of underlying disease. Conclusion. Suture annuloplasty is an effective and reliable method of correction MR of various etiologies accompanied by severe dilatation of MV annulus. There was no significant acceleration of blood flow within MV. The main causes of recurrent MR in the long term period were extraannular factors.