Mitral regurgitation affects 2% of the world population. Given its potential for severe clinical consequences, reliable assessment is essential for guiding treatment. While advancements in echocardiographic imaging have expanded available diagnostic techniques, no single method has become the gold standard. Current guidelines emphasize a multimodal approach assessing qualitative and quantitative parameters for comprehensive evaluation. This review examines the techniques utilized for mitral valve regurgitation (MR) assessment, discusses their advantages and limitations, and highlights the enduring need for an integrative approach. Despite continued progress, MR evaluation remains fundamentally reliant on the integration of multiple methods to achieve an accurate diagnosis and assessment.