Although the prevalence of rheumatic fever has greatly decreased in Western countries, mitral stenosis (MS) still results in significant morbidity and mortality worldwide. The treatment of MS has been revolutionized since the development of balloon mitral valvuloplasty (BMV). Until the first publication by Inoue in 1984, surgery was the only treatment for patients with mitral stenosis. Since then, the technique has evolved considerably. A large number of patients with varied conditions have now been treated worldwide, enabling us to assess the efficacy and risk of the technique, and long-term results make us better able to select the most appropriate candidates for treatment using this method.