Rupture of the sinus of Valsalva is a common complication of congenital aneurysm of the sinus of Valsalva. This event causes an abnormal communication between the aorta and other cardiac chambers via a fistula. Another cause of rupture of the sinus of Valsalva is infective endocarditis that may lead to multiple cardiac complications such as rupture of the aortic valve and fistula to the adjacent cardiac chambers. Rupture of the sinus of Valsalva to the right ventricle due to infective endocarditis is a very rare condition. This patient underwent surgery and the fistula between the right sinus of Valsalva and the right ventricle was repaired and the aortic valve was replaced (Iranian Heart Journal 2003; 4 (2,3):82-85).