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Obesity paradox existence-s been proposed this past decade, suggesting obese individuals may have survival benefit when there-s acute cardiovascular decompensation. Adiponectin-s known to have cardioprotective role against inflammation. We look at mitral valve stenosis (MS), feature of rheumatic heart disease (RHD), to determine relationship between body mass index (BMI) and degree of MS in RHD patients. Observational analytic study is done with cross-sectional method and consecutive sampling. 225 medical records enrolled from RHD patients at Noninvasive Diagnostic Division, Heart Service Installation, Dr. Hasan Sadikin General Hospital Bandung. Anthropometric measurement and echocardiography results taken and analyzed using Kruskal-Wallace followed by Mann-Whitney and Chi-square. Underweight, normal, overweight, and obese percentage are 16%, 52%, 15%, and 17% respectively. Severe MS distributed most in normal BMI group. In obese patients, MS distribution is moderate (6.2%), severe (5.8%), and mild (5.3%). Analysis shows the relationship between BMI and degree of MS (p<0.05). Median of mitral valve area (MVA) in obese group shows the greatest (1.2 vs 0.8-0.9) and significant (p<0.05). There-s significant relationship between BMI and degree of MS in RHD patients and greater median of MVA in obese group. Statistically, this may support the evidence of obesity paradox in RHD patients with MS.