In patients undergoing mitral valvuloplasty for mitral stenosis, an echocardiographic scoring system based on 1) leaftlet mobility, 2) valve thickening, 3) calcification, 4) subvalvular thickening can be used to predict the procedural outcome. Each item is graded from 1 (normal) to 4 which yield a score from 4 to 16. A score of 8 or less predicts a more favorable outcome than those with a higher score. However, a score higher than 8 does not exclude a patient from having a mitral valvuloplasty. Commissural calcification or fusion is another important predictor for poor outcome after mitral valvuloplasty.