Objective:To evaluate the effect of percutaneous balloon valvuloplasty(PBMV) in the elderly cases and study the adaptation and management with PBMV in these cases. Methods:This was a prospective single center clinical trial. A total of 56 cases whose age ≥60 years old were performed with modify Inoue PBMV. The hemodynamics and echocardiogram were used to evaluate the left atrial pressure(LAP), mitral valve area(MVA), mean gradient across the mitral valve(MVG), left atrial diameter(LAD) before procedure and immediately after procedure. The echocardiography assessment items before and one year after procedure included the MVA, MVG and LAD. Results:54 cases had successful operation in 56 paitents. 2 cases were failure. LAP from(22.5 ± 6.2)mmHg(1 mmHg = 0.133 kPa) before the operation decrease to(13.8 ± 4.6)mmHg immediately after the operation,(P < 0.01). MVA from(1.05 ± 0.21)cm2 before operation increase to(1.78 ± 0.22)cm2 immediately after operation(P < 0.01). MVG from(18.3 ± 5.2)mmHg before operation decrease to(10.6 ± 4.2)mmHg immediately after operation(P < 0.01). LAD from(4.71 ± 0.73)cm decrease to(4.39 ± 0.48)cm(P < 0.01) one year after operation. Restenosis detected by echocardiography was seen in 3 cases. One case died in mitral valve replacement performed. The echocardiography one year follow-up result showed that the effect of PBMV was constant. Conclusion:PBMV may be performed safely and successfully in old patients with mitral valve calcification and high risk, who can not afford mitral valve replacement.