In addition to a typical pattern indicative of mitral stenosis, the M-mode echo-cardiogram of a patient with mitral valve disease revealed a broad band of dense echoes within an enlarged left atrial cavity that was suggestive of an intraatrial thrombus. Subsequent cross-sectional echocardiography demonstrated a globular cluster of echoes inside the left atrial cavity, thus corroborating our interpretation of the M-mode recording. When open mitral commissurotomy was performed, a large, partially calcified thrombus was found protruding from the posterior wall and left atrial appendage into the atrial cavity. Postoperative M-mode and cross-sectional echocardiography did not show the previously noted abnormal echoes within the left atrium.