Pregnancy is a hyperdynamic state characterized by an increase in cardiac output, heart rate and oxygen consumption. The hemodynamic changes associated with pregnancy may be viewed as normal adaptation to the 15–20% increase in oxygen consumption required by the fetus. During the first trimester, blood volume increases up to 60% above the values in the nonpregnant state. This chapter covers the medical therapy, interventions in mitral stenosis in pregnancy, percutaneous mitral valvotomy (PMV) in pregnancy, and short- and long-term outcomes following PMV in pregnancy. Percutaneous mitral valvotomy is an effective alternative for the management of patients with mitral stenosis during pregnancy. It was first performed by Inoue et al. in 1984 and has proved to be a safe procedure for the mother and child, with outstanding short-term results.