Percutaneous balloon mitral valvuloplasty (PBMV) described by Inoue et al, is a safe FDA (Food and Drug Administration) approved procedure in patients with severe mitral stenosis. One of the contraindications of the procedure is presence of a left atrial thrombus; however, it has been reported that intense warfarin therapy may led to dissolution of the thrombus. The authors report a patient who was referred for PBMV and was found to have a left atrial thrombus. After intense warfarin therapy, successful PBMV was undertaken without complications.