The left coronary artery from the right sinus of Valsalva represents an incidence of 0.017% of angiographic series and 1.3% of total coronary anomalies of angiographic series. The anomalous left coronary artery arising from the right sinus of Valsalva may take either a septal, anterior, interarterial or posterior course. Sudden death is thought to result from transient occlusion of anomalous left coronary artery, particulary when the anomalous artery passes between the aorta and the pulmonary trunk. The left coronary artery from the right sinus of Valsalva with posterior course are thought to be benign anomalies, although rarely myocardial ischemia may occur. A 69-year old woman died suddenly at rest. Coronary angiography revealed that anomalous left coronary artery origin from right sinus of Valsalva without any significant stenotic lesion, the anomalous left coronary artery passed posterior to the aorta. We report the patient with anomalous origined left coronary artery and its course posterior to aorta associated with the sudden death.