During the period from September 2000 to August 2001, the patient study was done on rheumatic heart patients attending the the Rheumatic fever clinic of the Pediatric Hospital, Cairo University. The aim of the study was to outline the magnitude of rheumatic fever problem in Egypt focusing on rheumatic heart disease. Total number of rheumatic cases that attended the Cardiology Clinic from September 2000 till the end of August 2001 was 266 cases. Rheumatic heart disease was detected in 155 patients accounting for 58.26%. The age of rheumatic heart affection was between 3 and 15 years with the peak incidence between 10 and 12 years (29.67%). As regard sex distribution, there is a slight female predominance. The peak incidence of rheumatic heart presentation was during autumn (37.41%). The commonest presenting symptom of rheumatic heart patients was joint affection in its two forms, arthralgia and arthritis.Valvular involvement varied among RHD patients studied here, however, mitral regurge (MR) was present in 90 % of all cases with RHD. It was isolated in 60% and in combination with other lesions in 29% of cases. Evaluation of the prophylaxis program against rheumatic fever in our clinic showed that 94.19% of our cases received parenteral long acting penicillin (benzathine penicillin G 12 million units IM/2 weeks).