Persistent left superior vena cava is a rare disorder which is asymptomatic and hence is usually discovered while performing interventions through left sub clavian vein. Electrode instability & displacement have been reported in patients who underwent pacemaker Implantation via persistent left superior vena cava. An active – fixation system & sometimes epicardial pacing is necessary to maintain pacing stability. We report the case of a 60 years old man with a persistent left superior Vena cava who required Permanent Pacemaker Implantation. Passive fixation ventricular lead was successfully inserted and produced good long term pacing & sensing. To best of our knowledge, this is the first reported case of Implantation of a passive fixation single chamber pacemaker via persistent left superior vena cava in North East India.