Single coronary artery is rare and the application of coronary angioplasty to these arteies presents unique technical challenge. As technical advances in the guiding catheter and balloon system occur, more challenging lesions including anomalous coronary artery are able to be treated. Correct guiding catheter selection is important to ensure adequate access to the anomalous vessel and provide support to cross the lesion. This report describes successful angioplasty with stent in right coronary artery of single ostium coronary anomaly in a patient presenting with an acute myocardial infaction.