Objective: we sought to compare long-term results of three techniques: CMC, OMC and PMC in patients with rheumatic mitral stenosis. Patients and Method: Between January 1994 and December 2015, 183 patients underwent mitral valve surgery for rheumatic mitral restenosis. All patients were investigated by echocardiography-Doppler performed by a senior cardiologist. The patients were divided into 3 groups: patients who have previously closed mitral commissurotomy (CMC n = 101), patients with previously open mitral commissurotomy (OMC n = 28) and those treated by Balloon mitral valvuloplasty (PMC = 54). Results: The three groups were comparable in term of major demographic data. Mitral restenosis occurred precociously in groups treated by PMC (7 ± 4 years), followed by group with OMC 11.4 ± 4 years and CMC group but it occurred later CMC 16.8 ± 7.8 years (p < 0.01). No statistical difference was found in perioperative and postoperative data. Conclusion: CMC produces better long-term outcome than OMC and PMC. However, it would be premature to conclude to its superiority.