The present study is an up-date on rheumatic fever for the last ten years. The disease has erroneously been considered to have largely or completely disappeared whereas epidemiological data show it to be still prevalent especially in the developing countries. However, in the industrialized countries, too, its prevalence is by no means negligible; e.g. in the US the last ten years have witnessed an alarming recrudescence involving vast strata of the population and especially children, although this is masked by the paucity of reports, as is the case also in Italy. Chemoprophylaxis is then discussed. This is highly successful, especially if applied at an early stage, and finally therapy is described in great detail.