While valvular involvement of rheumatic heart disease can be easily detected with conventional echocardiography by evaluating morphologic change of the valve, it still remains problematic to determine whether there is myocardial fibrosis after rheumatic fever and if yes, how much extent it involves. This case demonstrated that contrast-enhanced magnetic resonance imaging could exactly detect and define the extent of myocardial fibrosis in a patient with rheumatic valvular heart disease by comparing surgically obtained tissue analysis.