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Purpose: As compared to developed nations, in developing countries especially Indian subcontinent population overload, mal-nutrition, poor socio-economic status of affected group and health care facilities affect the outcome of treatment. A surgical intervention with comparable short and long term results along with low cost and wider group of patient population included (pregnant females, young adults and restenosis cases) is definitely need of the time. Closed Mitral Valvotomy (CMV) therefore essentially remains modality of treating the Mitral stenosis of favourable morphology as it caters to above challenges. Where percutaneous procedures are unavailable due to financial con-straints and open surgical management cannot be offered due to overburdened and limited resources CMV provides an excellent choice with convincing immediate and late outcomes in favourable mitral valve pathology. Methods: We reviewed the literature for various valvotomy techniques done for mitral valve stenosis and restenosis. Immediate and late outcomes were compared between the patients receiving Percutaneous Balloon Mitral Valvotomy (PBMV) and Closed Mitral Valvotomy (CMV). Results: The immediate and late term results are comparable for PBMV and CMV. Complications developing in both the techniques are also nearly similar. CMV holds important role in excellent palliation provided to child bearing age mothers and young adults suffering from mitral valve pathology of favourable morphology because its cost effectiveness and freedom from hazardous side effects of anticoagulation are promising. Conclusion: With excellent immediate and late outcomes, CMV stands as procedure of choice for favourable mitral valve morphology where our resources are limited and overburdened. It is life saving and definitely not obsolete. [ABSTRACT FROM AUTHOR]