The major aim of this study was to determine the prevalence of rheumatic heart disease in Yemen. Between October 1997 and March 1998, a prospective cluster-sampling screening study was carried out on 5000 schoolchildren (2504 female and 2496 male), aged 5 to 18 years. Suspected cases were subjected to electrocardiography, chest radiography, and Doppler echocardiography. Although no case of active rheumatic fever was found, 12 girls and 6 boys were affected by the disease, giving a prevalence of 3.6 per 1000, which is higher than that reported from neighboring countries. All confirmed and suspected cases were given penicillin G benzathine every 3 weeks, according to body weight, after a test dose. Prevention programs for rheumatic fever, together with prevention of streptococcal throat infections, are goals for the near future.