In the past decade, the treatment of aortic regurgitation has evolved from a strategy focused mainly on valve replacement to one of valve repair (AVr). Nevertheless, AVr has yet to gain broad acceptance within the surgical community despite excellent reported results in selected centers. In fact, AVr failure due to recurrence of regurgitation remains a challenge. Thanks to sustained research efforts, the mechanisms underlying aortic valve repair failure are now better understood. The aim of this article is to discuss the risk factors for recurrent AR after valve repair, the technical strategies that can mitigate this risk and highlight the contemporary results associated with AVr.