Rheumatic fever is the main etiology for valvular heart diseases in children. Valvular insufficiencies are frequent, and development of disease at an earlier age results in severe valvular damage. In this report we present a 9-year-old child with rheumatic heart disease who was admitted to our clinic with hemoptysis and haematemesis caused by mitral stenosis (MS) resulting in pulmonary venous hypertension. The child was treated with mitral balloon valvuloplasty by hybrid approach. Percutaneous mitral balloon valvuloplasty is used for management of MS in adults, but it is less frequently used in children because of its high rate of complications. Because of the severity of disease with which this patient presented, as well as her younger age and lower weight, we preferred to use the hybrid approach, and the results were favorable. In conclusion, in patients with special conditions, hybrid mitral valvuloplasty through the right upper pulmonary vein should be considered when managing children with similar conditions.