In the last years both minimally-invasive therapy approaches as well as intramyocardial cell therapy have entered clinical practice in cardiac surgery. Stem cell therapy has been combined in most cases with coronary artery bypass grafting (CABG) for chronic ischemic heart disease. Here, we report the first case of a patient with ischemic mitral regurgitation treated by videoscopic, transvalvular, intramyocardial bone marrow stem cell injection, while undergoing minimally-invasive mitral valve repair.