Background: This case report demonstrates the application of the Roman arch technique in addressing complex bileaflet mitral valve prolapse with concurrent relatively short anterior leaflet and huge posterior leaflet multi-scallop prolapse. Methods: Endoscopic mitral valve surgery was employed in this case with access through the IVth intercostal space on mid axillary line. The "Roman Arch" technique was employed as the primary repair strategy, offering a simplified approach to this complex pathology. Results: The Roman arch technique successfully addressed both the anterior leaflet deficiency and posterior leaflet prolapse. This approach provided effective leaflet remodeling while maintaining physiological valve dynamics. Conclusion: This case illustrates the versatility of the Roman arch technique in managing complex mitral valve pathologies, particularly in scenarios involving combined anterior and posterior leaflet abnormalities. The technique's reproducibility and effectiveness in addressing multiple components through a unified approach make it a valuable addition to the mitral valve repair surgeon's toolbox.