This chapter discusses transjugular percutaneous mitral valvotomy. Since, the introduction of Inoue balloon in 1984, it has been extensively used worldwide in percutaneous mitral commissurotomy (PTMC) because of its efficacy, low-risk of complications and, especially, ease of the procedure with a short learning curve. Advantage of transjugular venous access is clearly demonstrated among mitral stenosis patients who have venous abnormalities caused either by congenital or acquired disorders that preclude transfemoral PTMC. This chapter covers the transjugular interatrial septal puncture, procedure of septal puncture, mitral valve dilatation procedure, and complications. Procedure-related complications including cardiac tamponade, emergency surgery, severe mitral regurgitation and embolization have been reported and are assumed to be similar to transfemoral approach.