We describe the case of a 30-year-old man with systemic lupus erythematosus (SLE) and he was struck with non-ST segment elevation myocardial infarction: this was due to the presence of multiple coronary artery aneurysms those were full of thrombi. A diagnostic coronary angiogram revealed huge dilatations in the proximal three coronary arteries with multiple filling defects and a decreased flow rate, and these were suggestive of thrombi within the coronary artery aneurysms. An intravascular ultrasound (IVUS) examination revealed huge aneurysmal dilatations with movable thrombi in three coronary arteries. He had an uneventful recovery without us having to perform any percutaneous coronary intervention.