The International Symposium on Ischemic Mitral Incompetence was held December2-4,1988 at the Intercontinental Hotel, Berlin . It wasorganized bythe German Heart Center Berlin with the primary aim to bring together experts interested in the subject of ischemic mitral regurgitation. Our intention was to face the problems associated with diagnosis and treatment of mitral incompetence resulting from coronary artery disease. A "work-up" of the whole topic from its basic, diagnostic, and surgical aspects wasinitiated. In the first section weconcentrate on the basic anatomical and pathophysiological knowledge, as well as on experimental work. In the second section cardiologists report on inci- dence of ischemic mitral incompetence, diagnostic methods that include esophageal echocardiography, follow-up studies of medical- and surgical-treated patients. This section considers interventional therapy in acute myocardial infarc- tion, as well. The third section includes contributions by cardiac surgeons with many years' experience in operative treatment of ischemic mitral incompetence including the decision-making criteria for non-mitral valve surgery, and for valve reconstruction or replacement.