Coronary artery fistulas are uncommon occurrences which usually pass asymptomatic. Coronary cameral fistulasare rare subsets of coronary artery fistulas. These are formeddue to abnormal communication between coronary artery andone of the cardiac chambers [2]. It is commonly congenital and asymptomatic in majority of patients. Here we present a case of 14–year–old asymptomatic male incidentally picked with bruit during cardiac auscultation when presenting for urinary tract symptoms. ECG was unremarkable except for Left ventricle volume overload pattern. The Echocardiogramshowed dilated left ventricle with a fistula from left main coronary artery to right ventricular apex. Digital subtraction angiography was also in concordance with fore mentioned findings. CT coronary angiogram was done for detailed evaluation. CT showed dilated left main coronary artery with a dilated Left anterior descending branch with a fistulous communication to right ventricle.