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Infective endocarditis is an infection of the endocardium of heart and its great vessels. Infective endocarditis if complicated by abscess may lead to severe valvular insufficiency and intractable heart failure. Leaflet abscess although is a very rare complication, but if occurs, leads to increased morbidity and mortality. We report a case of 28-year-old female who had severe mitral valve regurgitation with mitral leaflet abscess confirmed by transesophageal echocardiography. She developed cardiogenic shock, multiple organ dysfunction syndrome with anemia, leukocytosis, thrombocytopenia, liver dysfunction, acute renal failure, and splenic abscess. Due to these multiple comorbid conditions, it could be a very high-risk surgery. Hence, she was managed with medical therapy and responded well.