A 22 year old female with severe calcified mitral stenosis with moderate PAH (grade 4 NYHA) presented at 28 weeks of gestation. Patient was referred from a cardiologist for immediate caesarean and cardiac surgery for severe pulmonary hypertension. A multidisciplinary team including cardiologist, cardiac surgeon and obstetrician decided to assist the parturient in continuing her pregnancy under close monitoring till 3536 weeks of gestation. At term, the patient underwent a successful elective cesarean section followed by concomitant mitral valve replacement under cardiopulmonary bypass. A live healthy female child weighting 1.67 kg was delivered and shifted to NICU. It was a real challenge to continue pregnancy with critical mitral stenosis (size = 0.6 cm2), fortunately both fetal and maternal outcome were excellent. Both mother and child were discharged from the hospital after an uneventful postoperative recovery.