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Rheumatic fever (RF) and its long-term complication, rheumatic heart disease (RHD), are now very rare in metropolitan France, a situation consistent with other high-income Western European nations. The dramatic decline in incidence began in the mid-20th century due to significant improvements in living standards, sanitation, and, crucially, the widespread and prompt use of antibiotics for treating Group A Streptococcus (GAS) throat infections, which are the precursor to RF. Hospital-based studies conducted in France have shown a very low prevalence of RHD in adults and children, with new cases of acute rheumatic fever being exceptional in pediatric departments. However, it is important to note that cases of RHD in France are disproportionately found among immigrants and foreign-born individuals who have moved from areas where the disease remains endemic, such as parts of Africa, South Asia, and the Pacific. Furthermore, France's overseas territories, such as New Caledonia, can still face a significant…