A 38-year-old woman in the 37^th week of pregnancy was admitted for acute presentation of severe cough and aggravated dyspnea. She was previously diagnosed with rheumatic heart disease (RHD) at the age of 31. During the present pregnancy, she reported at 37 weeks and had RHD, severe mitral stenosis, secondary pulmonary hypertension, and heart failure. As a consequence, the patient underwent an emergency cesarean section followed by reoperative mitral valve replacement, which was successfully under a cardiopulmonary bypass (CPB). In this report, the authors present the successful experience of management of severe mitral stenosis in pregnancy.