Percutaneous balloon mitral valvuloplasty (BMV) is an effective and safe method in treating rheumatic MS when performed by an experienced operator in a carefully selected patient. A successful BMV procedure results in reducing the symptoms and improving the long-term outcome of the patients. Of the different proposed techniques, the Inoue balloon technique is the most frequently used. Appropriate patient selection using clinical and echocardiographic characteristics is of paramount importance for achieving acceptable final results. Complications are infrequent but can cause significant morbidity and even mortality. Special subgroups of patients might also benefit from BMV, including pregnant women, older patients with rigid valves, and those with mitral valve restenosi