Introduction: M is a new variant of double-balloon technique for PTMC, with encouraging results and low procedural cost. This study is designed to compare its immediate and short term results with those of the most popular widely-used Inoue balloon.Methods: Between November 2000 to March 2002, go consecutive patients with symptomatic mitral stenosis underwent PTMC, using either the Multi-Track System (n = 30, group M) or the Inoue balloon (n = 30, group I), by an alternating sequence.Results: Before dilatation, patients included in both groups had comparable baseline clinical characteristics and echocardiographic variables.The success rate was 80% in group M, and 96.7% in group I (p = 0.1). technical failure occurred in group M only (4 cases). After dilatation, the final MVA in group M (2.04 ± 0.37 cm2) was significantly higher compared to group I (1.82 × 0.23 cm2) (p = 0.02). Also, the Multi-Track technique showed superior results to the Inoue balloon in the % change in cusp separation distance after PTMC (68% vs 43%, p = 0.005). The Inoue procedure was significantly shorter in time than the Multi-Track procedure (35.7 ± 9.3 min vs 57 ± 24.4 respectively, p = 0.001). There was no significant difference between both groups after dilatation regarding other functional variables (as decrease of mean gradient, left atrial diameter, pulmonary artery systolic pressure an increase in fractional shortening) and morphological variables (as commissural splitting).The incidence of serious complications was not significantly different between both groups as regards severe mitral regurgitation, atrial septal defect, cardiac tamponade, arrhythmias, hypotension and local vascular complications. The only difference was the incidence of transient seizures, as it occurred in 5 cases in group M only.The reuse of balloons after sterilization was an important issue in this study. The use of new Multi-Track Kit is crucial for good immediate results with low risks. Reused Multi-Track Kit lost the advantage of superior results achieved by a new kit, with a higher rate of technical failure and complications. In contrast, reused Inoue balloon showed comparable results to those of new Inoue balloon short term follow-up results showed no significant difference from those obtained immediately after dilatation in both groups.Conclusion: The Multi-Track System, when it is new and not reused, is an effective alternative to the widely used Inoue balloon with good immediate and short term results.