Background: Mitral stenosis is a valvular heart disease characterized by the narrowing of the orifice of the mitral valve of the heart.The treatment of rheumatic mitral stenosis ranges from conservative medical management to CMV,OMV,BMV or mitral valve replacement with prosthetic valve. Methods: The study based on randomized 60 consecutive patients with severe rheumatic mitral stenosis [defined as mitral valve area less than 1 cm²] who were alternately assigned to undergo either CMV or PTMC. Results: Results were reduction in peak transmitral gradients in both the groups along with improvement in mitral valve area and reduction in LA diameter in time. Conclusion: Both closed mitral valvotomy and PTMC are successful means of treatment with a gain in valve area and reduction in transmitral gradient. Though, no mortality was in CMV group, one death was reported in the PTMC group.