Background:  In low-income nations, Rheumatic valvular heart disease remains a major cause of morbidity and premature deaths. Accurate prevalence data in Egypt are still lacking yet highly desirable to facilitate healthcare planning. Aims of study: To detect the prevalence of rheumatic heart disease among school students aged 12-18 years old in a rural village of Minia district, and investigate the effect of family living conditions as a risk factor. Methods: This study is cross-sectional study carried out among school students of Damshir preparatory and secondary school which was selected randomly among 192 villages of Minia district to represent the rural areas. Data was collected during the period from October to December 2023 through a designed well-structured sheet included socio-demographic and clinical data of children. Results: Findings revealed that more than half of the studied students (59.6%) were females and their mean age was 14.8 ±1.6 years.  Among 403 students aged from 12-18 years attending Damshir preparatory and secondary school 10 students were diagnosed with definite rheumatic heart disease and the prevalence was estimated to be 2.5%. About 90% of students with definite rheumatic heart disease were females compared to 58.8% of students with normal ECHO findings (p=0.04). Multiple logistic regression analysis demonstrates that there was a significant association between age and history of tonsillitis with rheumatic heart disease. Conclusions: Rheumatic heart disease is an important health problem among school students of rural areas of Minia District. Several factors like age, sex and tonsillitis history can affect rheumatic heart disease.