Background: Para-prosthetic leakage (PPL) is a significant complication following mechanical prosthetic mitral valve replacement, potentially impacting patient outcomes. The choice of suturing technique, continuous or interrupted, plays a pivotal role in determining the frequency and severity of PPL. Objective: To compare the frequency of para-prosthetic leakage in patients undergoing mechanical prosthetic mitral valve replacement using continuous versus interrupted suturing techniques. Methods: This observational study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from September 2015 to August 2017. A total of 40 patients requiring mitral valve replacement were included and randomly divided into two groups: Group A (continuous suturing, n=20) and Group B (interrupted suturing, n=20). Baseline demographic and clinical data were recorded. The primary outcome was the incidence of PPL, assessed by transthoracic echocardiography at one month postoperatively. Results: The mean age of the patients was 37.3±11.5 years in Group A and 40.2±11.1 years in Group B. Mild PPL was observed in 15% of patients in Group A and 10% in Group B, a difference that was statistically nonsignificant (p>0.05). PPL jets in both groups were predominantly mild and clinically insignificant. The continuous suturing technique was associated with significantly shorter cross-clamp (57.8±22.4 vs. 77.5±18.6 minutes; p<0.05) and bypass times (105.9±37.3 vs. 134.7±33.2 minutes; p<0.05) compared to the interrupted technique. Conclusion: Both suturing techniques demonstrated comparable rates of para-prosthetic leakage, with a slight, nonsignificant trend toward reduced PPL in the interrupted group. However, the continuous suturing technique provided the advantage of reduced operative times. Further large-scale studies are recommended to validate these findings.