This chapter describes long-term follow-up of patients undergoing percutaneous mitral valvotomy (PMV). Several prospective studies have demonstrated the efficacy of PMV and found it to be comparable or better than surgical commissurotomy in terms of improvement in hemodynamics and betterment of functional status. Restenosis rates were also comparable between the two treatment modalities (25% in PMV and 27% in closed surgical commissurotomy) at up to 15 years of follow-up. Longterm results can be predicted by preoperative valve morphology and clinical characteristics, and the quality of the immediate results. This chapter covers the factors affecting long-term prognosis after PMV, clinical course of tricuspid regurgitation, mitral restenosis and long-term outcome, follow-up and management of patients after PMV, and infective endocarditis prophylaxis.