Balloon dilatation of the stenosed mitral valve, in an attempt to relieve symptoms, was developed to replace the surgical procedure of closed mitral valvotomy. This procedure, whereby a balloon tipped catheter is introduced from the femoral vein and directed across the mitral valve after an atrial septal puncture, was developed in 1982. The procedure was first performed at Groote Schuur Hospital in 1988. Two types of dilating balloon (Inoue and Bifoil types) have been used. The aim of this retrospective study was to analyze the results of balloon mitral valvuloplasty procedures performed from 1988 until November 1992. In addition a detailed analysis was made of all complications of the procedure. 118 patients (mean age 30.7 years) underwent 124 attempted procedures. 93 % of attempts were successfully completed and an optimal result was achieved in 76% of patients. Mitral valve area increased from 0.9cm² to 2.0cm². Equivalent results have been achieved with both balloon types. Death occurred in 1.6 % of patients. 2.4 % of patients had severe mitral regurgitation as a complication. 4% of procedures resulted in cardiac chamber perforation. The experience at Groote Schuur has been similar to other centres treating young patients with rheumatic mitral stenosis.