The mitral valve plays a vital role in our circulatory system. To study its functionality, it is important to measure clinically relevant parameters, such as its thickness, mobility and shape. Since manual segmentation is impractical, time consuming and requires expert knowledge, an automatic segmentation tool can have a significant clinical impact, providing objective measures to clinicians for understanding the morphology and behaviour of the mitral valve. In this work, a real time tracking method has been proposed for ultrasound videos obtained with the Parasternal Long Axis view. The algorithm is semi-automatic, assumes manual Anterior Mitral Leaflet segmentation in the first frame and then it uses mathematical morphology algorithms to obtain tracking results, further refined by localized active contours during the whole cardiac cycle. Finally, the medial axis is extracted for a quantitative analysis. Results show that the algorithm can segment 1137 frames extracted from 9 fully annotated sequences of the real clinical video data in only 0.89 sec/frame, with an average error of 5 pixels. Furthermore, the algorithms exhibited robust tracking performance in the most difficult situations, which are large frame-to-frame displacements.