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To assess five-year results after successful percutaneous mechanical mitral commissurotomy (PMMC).Methods Thirty-four selected patients with rheumatic mitral stenosis underwent PMMC successfully in Guangdong cardiovascular institute between February 2001 and August 2002. Serial echocardiograms were performed in all patients at baseline, discharge and annually thereafter. Results Five-year follow-up rate was 97. 1%. Five-year survival rate was 100%. Before and after PMMC and at follow-up, mean mitral valve area by two-dimensional echocardiography was (0. 87 ± 0. 15 ) cm2, (2. 11 ± 0. 38 ) cm2 and (1.81 ± 0. 36) cm2, respectively (P＜ 0. 01 ). Five-year mitral resteno sis rate was 6. 1%. Conclusion PMMC can achieve excellent and sustained long-term results in selected patients with mitral echocardiographic score exceeding or being equal to 9.