During the past three decades, balloon valvotomy has revolutionized the approach to stenotic heart valves and has become the standard treatment modality in all age groups in most centers demonstrating optimal clinical outcomes with evolving techniques. Psychologically also, there is more acceptability as there is no thoracotomy scar, no general anesthesia, no regular use of blood transfusion, less hospitalization, lesser morbidity and mortality, as well as possibility of repeat valvuloplasty for restenosis avoiding risk of thoracotomy. The prerequisite of availability for closed and opened heart surgery should be kept in mind even with experienced operators and in centers performing balloon valvuloplasty on routine basis.