Congenital coronary artery fistula is a rare malformation with an incidence of 0.4% of congenital heartdisease. Among the various subtypes, fistula to the left ventricle is extremely rare with 6 reported cases till 1983. We present a case of coronary artery fistula between the right coronary artery and the left ventricle. Thedilated right coronary artery formed a mass like bulging the right lower heart border in the plain chest PA, wethink this is first case with a coronary artery fistula to the left ventricle, reported in Korea.