Background: rheumatic heart disease (RHD) is still prevalent in the developing countries and poses major medical and cardio-thoracic surgery challenge in Egypt.

Aims: Our aim is to provide a description of the current clinical profile of RHD and Rheumatic Fever (RF).

Methods: This study was conducted on 112 patients with RF diagnosed to the revised Jones criteria and 280 patients with RHD; their diagnosis was based on an Australian guideline.

Results: rheumatic arthritis was detected in 50 patients (44.6%), followed by carditis in 34 patients (30.4%), chorea in 8 patients (7.1%), arthritis and carditis in 8 patients (7.1%), arthritis and chorea in 6 patients (5.4%), while concomitant carditis, arthritis and chorea were detected in 3 patients (2.7%). During the follow up period, 63 patients (56.3%) improved, 46 patients (41.1%) were changed to chronic rheumatic avlvulitis and 3 patients (2.7%) died.

In RHD patients, mitral valve affection was detected in 143 patients (51.1%) followed by aortic valve in 88 patients (31.4%), concomitant mitral and aortic valves involvement in 45 patients (16.1%) while the tricuspid valve affection was detected only in 4 patients (1.4%) and there was no affection of the pulmonary valve.

Conclusion: RF and RHD are still remaining a major health problem in our locality. Rapid increasing population without equal increasing  in the level of socioeconomic status is one of the major predisposing factors.