Although percutaneous balloon mitral valvuloplasty is known to be a safe and effective procedure during a singleton pregnancy, its use during a twin gestation is limited to a single report with a poor obstetric outcome. In the case we are reporting, a 29-year-old nulliparous patient with a twin gestation was seen at 24 weeks' gestation with congestive heart failure caused by previously undiagnosed mitral stenosis. She had successful percutaneous balloon mitral valvuloplasty, and two healthy infants were subsequently delivered at 36 weeks' gestation.