Comparison of different gadgets used for percutaneous mitral valvuloplasty (PMV) should be done by comparing the acute and the long-term results of the procedure. The acute results of PMV in the catheterization laboratory can be assessed using invasive hemodynamics or echocardiography. Post-procedure, the most accurate evaluation of valve area is given by echocardiography using planimetry method. The assessment of mitral regurgitation (MR) is usually done by Doppler color flow. The only study in the literature that compared all the techniques of PMV was conducted by Sherif. El-Sayed reported the first comparative study between Inoue balloon technique (IBT), double balloon technique (DBT), and metallic commissurotome. Several studies, both randomized and non-randomized, compared IBT to the DBT are discussed in this chapter.