Mitral regurgitation (MR) is a common subtype of valvular heart diseases in clinical practice. Based on etiology, it is classified into primary mitral regurgitation (PMR) and secondary mitral regurgitation (SMR). Intrinsic abnor-malities of the mitral valve apparatus cause PMR. Consequently, drug therapy has a restricted role, being primarily aimed at alleviating the symptoms of heart failure. SMR results from abnormalities in left heart structure or function, and drug therapy is the cornerstone of its definitive management, effectively reducing regurgitation severity, improving prognosis, and paving the way for potential interventional therapies. For the atrial SMR, treatment must additionally address the underlying etiology, such as atrial fibrillation or heart failure with preserved ejection fraction. However, the current pharmacotherapy for MR still faces challenges such as insufficient evidence, suboptimal drug use, and poor drug tolerance. Based on this, this article summarizes the latest research progress in the pharmacological treatment of MR, aiming to provide references for clinical treatment decisions and future research directions.

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