OBJECTIVE： To compare therapeutic efficacy and safety of nifedipine and atenolol in the treatment of moderate mitral stenosis in sinus rhythm rheumatic heart disease. METHODS： In retrospective analysis， a total of 108 patients with moderate mitral stenosis in sinus rhythm rheumatic heart disease were divided into nifedipine group （54 cases） and atenolol group （54 cases） according to therapeutic regimen. Based on routine treatment， nifedipine group was given Nifedipine sustained-release tablet （Ⅰ） 20 mg orally， once a day. Atenolol group was given Atenolol tablet 50 mg orally， once a day. Both groups received treatment for 8 weeks. Clinical efficacies as well as resting heart rate， cardiac function indexes （LVESV， LVEDV， LVET， LVEF， LVMI， E/A）， BNP and hs-CRP levels， 6 min walking distance， the occurrence of ADR before and after treatment were observed in 2 groups. RESULTS： There was no statistical significance in total response rate and the incidence of ADR between 2 groups （P＞0.05）. Before treatment，there was no statistical significance in the levels of resting heart rate，cardiac function indexes，BNP and hs-CRP，6 min walking distance between 2 group （P＞0.05）. After treatment， resting heart rate， LVMI， BNP and hs-CRP levels of 2 groups were significantly lower than before treatment， and LVMI， BNP and hs-CRP levels of nifedipine group were significantly lower than those of atenolol group； LVESV， LVEDV， LVET， LVEF， E/A and 6 min walking distance of 2 groups were significantly higher or longer than before treatment， and LVESV， LVET， LVEF， E/A and 6 min walking distance of nifedipine group were significantly higher than those of atenolol group； there was statistical significance （P＜0.05 or P＜0.01）. There was no statistical significance in resting heart rate and LVEDV between 2 groups （P＞0.05）. CONCLUSIONS： Based on routine treatment， nifedipine is similar to atenolol for moderate mitral stenosis in sinus rhythm rheumatic heart disease in therapeutic efficacy and safety. But nifedipine is better than atenolol in improving cardiac function， neuroendocrine factor levels and exercise ability.