Fifteen years of experience with percutaneous valve dilatation for mitral stenosis have shown the following: it is an effective treatment in a wide range of patients; its risk is low when it is performed by experienced teams, and more than 10 years follow-up demonstrates excellent durability of the procedure; the prediction of the immediate and long-term results is multifactorial and based on clinical and anatomic variables which should be taken into account when selecting the candidates for the procedure. Today balloon commissurotomy is a substitute for surgical commissurotomy and a complement to valve replacement.