Rheumatic heart disease (RHD) is one of the important public health problems globally especially in low-and middle- income countries. Since, India is home to nearly 40% of the global burden of RHD and these operational guidelines were developed with an aim for 25% relative reduction in the mortality due to RHD through early diagnosis and management of cases. Guidelines were developed in four steps. In first step, a thorough review of literature was done and level 1 and level 2 evidences were included. In second step; the draft was shared with the expert group at PGIMER, Chandigarh and programme officers for review and inputs. In third step, National expert committee reviewed the guidelines and proposed evidence-based suggestions. In the fourth step, a summary of the best available evidences, together with recommendations from experts, were compiled and final version of the guideline document was prepared. The key focus of the guidelines is on prevention, early identification and adequate treatment of streptococcal pharyngitis, acute rheumatic fever and rheumatic heart disease followed by secondary prophylaxis, surveillance and monitoring system which includes the establishment of central RHD Registry. Guidelines have also addressed RHD in women of childbearing age, prevention from complications and monitoring & evaluation of programme. Implementation of the RF/RHD interventions will be done through the existing National health programmes. The guidelines are developed in context of the LMICs and can be replicated as per the country programs guidelines.