“Mural infective endocarditis (MIE)” is a rare but deadly endocarditis complication. MIE patients have a poor prognosis despite diagnostic and treatment advancements. For optimal care and results, MIE patients' clinical features and prognostic variables must be identified. After one year, this study examined MIE patients' clinical features and prognoses. Methods: A retrospective study was piloted from the hospital records from august 2017 to September 2021 at a tertiary care facility retrospective research. All center visitors' medical records were reviewed. The study included Duke-identified MIE patients. Demographic, clinical, laboratory, microbiological, and imaging data were obtained. All-cause mortality at one year, cardiac and neurological problems, renal failure, emergency surgery, and composite embolic phenomena were secondary outcomes. Descriptive statistics, chi-square, and t-tests assessed data. Results: 35 MIE patients participated. Patients were 36.25±16.23 years old and 65% male. Fever (94%), dyspnea (51%), and chest discomfort (31%), were the main symptoms. The right ventricle has 43% of vegetation, followed by the left (29%). Staphylococcus aureus (74%). MIE patients had 80.3% of large vegetation (>10 mm) compared to 44.5% of valvular endocarditis patients (p=0.004). MIE had a 20% one-year death rate, while valvular endocarditis had 32.37% (p=0.43). Valvular endocarditis patients had 33% cardiac problems, while MIE patients had 0% (p=0.003). Valvular endocarditis patients had a 22% higher emergency surgery rate than MIE patients (p=0.02). Conclusion: In conclusion, MIE is a rare form of IE that requires a high index of suspicion for diagnosis. Its incidence in India is not well-known, and further research is needed to determine its burden and risk factors in the country. Increased awareness among physicians can help improve the diagnosis and management of MIE in India. Early diagnosis and appropriate management of MIE can improve patient outcomes and prevent complications associated with this rare disease.