Two large thrombi were discovered moving freely within the left atrium of a 45-year-old woman presenting with breathlessness, swelling, and recent stroke. Echocardiography revealed severe mitral stenosis and pulmonary arterial hypertension from rheumatic heart disease, as well as the two thrombi measuring 23x16mm and 24x18mm. The patient underwent mitral valve replacement and removal of the thrombi. Ball valve thrombi are rare occurrences where thrombi detach entirely from the atrium walls and move freely due to excess narrowing of the blood flow pathway. This case of two large moving ball valve thrombi in the left atrium without prior embolism is exceptionally rare.