Bioprosthetic valves are generally considered to carry a low risk of valve thrombosis, obviating the need for long-term anticoagulation in most patients. Few reports exist of the diagnostic characteristics and management of bioprosthetic valve thrombosis. Herein is presented a case of critical bioprosthetic mitral valve thrombosis in which successful clinical and hemodynamic resolution was achieved with intravenous thrombolysis. A current review of the bioprosthetic valve thrombosis literature is also presented.