Mitral valve prolapse (MVP) is very prevalent, affecting 2.4 % of the population, yet can be difficult to diagnose based on auscultation with the untrained ear. This chapter’s goal is to aid in the identification, pathophysiology and recommendations for MVP. A case of MVP is presented and discussed along with the risk factors, clinical basics and related heart anatomy. We discuss the auscultation features, maneuvers for altering the intensity and timing of the click, audio of this murmur, risk factors, annular calcification and myxomatous degeneration. The chapter is concluded with a discussion of the diagnostic and prognostic implications as well as the treatment recommendations based on the American Heart Association.