Based on the clinical, laboratory and instrumental studies made at the Cardiorheumatologic Department of the K.A. Rauchfuss City Child's Hospital in Leningrad the authors describe evolution shown by rheumatic fever in children over the recent 30 years. In their opinion, the cases of so-called classical rheumatic fever with moderate and maximal activity of the inflammatory process occurred more frequently over the recent years. In spite of this fact rheumatic fever in children is characterized today by the decreased number of relapses and by the reduced incidence of heart disease. Attention is drawn to the circumstance that over the recent years the pediatricians tend towards the underdiagnosis of rheumatic fever.