introduction and aim of the work:-mitral stenosis still shows it self older population in developed countries.Percutaneous balloon mitral Valvuloplasty (PBMV) is the treatment of choice for severe and /or hemodynamically significant mitral stenosis. It has been developed as an alternative modality to surgical closed commissurotomy for mitral steno-sis5. Elderly patients with mitral stenosis are a special entity who suffered a severe form of the disease and in the same time at higher risk of surgical mitral valve replacement, the aim of the current study is to assess and analyze clinical and echocardiographic consequences after percutaneous balloon mitral Valvuloplasty in those patients. Study design Uncontrolled prospective longitudinal single center study performed in patients referred for percutaneous balloon mitral valvuloplasty. Patients :-The current study included 40 elderly consecutive patients who underwent PBMV in Sohag university hospital cathlab unit. results and conclusion:-There was no in hospital mortality , only one patient developed severe MR , technical failure was encountered in 2 patients, because of failure of the balloon ability to traverse tight valves.This study agreed that PBMV can be applied to those with less favorable valve morphology, PBMV is a safe and effective procedure and optimal results can be achieved in patients with higher wilkin's score if they are carefully selected and operated at experienced centers.