In developing countries mitral stenosis is a frequent heart disease. The therapeutic management of mitral stenosis has been substantially improved through the development of percutaneous mitral commissurotomy, whose safety and efficacy have been demonstrated in many studies. The aim of this work is to study the immediate results of percutaneous mitral commissurotomy (PMC) in patients with severe mitral stenosis managed in Center of cardiology-University Hospital IBN Rochd-Casablanca. Of 150 patients there were 20 men and 130 women including 10 pregnant women (third trimester of pregnancy), their mean age was 35 ± 10 years. One hundred were in NYHA class II, 40 in class III and 10 in class IV. Eighty patients with atrial fibrillation. All patients had transthoracic echocardiography before and after the procedure and transesophageal echocardiography before the PMC. Wilkins score calculated in all patients with an average 7 ± 4. Grade 1+ mitral regurgitation was present in 70 and grade 2+ in 13. Mitral regurgitation grade I or II developed in 8 patients. The PMC was converted into a mitral replacement surgery in one patient. Tamponade occurred in one patient. No patient died. Mitral surface area and hemodynamic parameters improved significantly after PMC; mean left atrial pressure fell from 18.76 ± 6.18 to 10.65 ± 4.38 mmHg (P < 0.001), mean transmitral gradient from 14.03 ± 4.70 to 4.63 ± 2.05 mmHg (p < 0.001) and mitral valve area from 0.99 ± 0.22 to 1.88 ± 0.41 cm2 (p < 0.001). In conclusion, PMC is a safe and effective treatment in a wide range of patients with mitral stenosis.