The incidence of angina pectoris(AP) in patients with severe aortic stenosis(AS) and normal coronary arteries has been reported to be 30 to 40%. The pathophysiologic mechanism suggests marked decrease in coronary rederve with left ventricular hypertrophy secondary AS and mismatched oxygen demand-supply by valvular pressure gradient, but only 1 case of acute myocardial infarction(AMI) was reported in severe AS and normal coronary arteries as far as we are concerned. We report a case of AMI occuring in a patient with severe AS and left ventricular hypertrophy. A coronary angiogram excluded coronary obstruction and spasm as the cause of AMI in this patient.