There is a paucity of data on pseudoaneurysms of native coronary arteries; however, several reports exist on coronary artery aneurysms, which occur in approximately 1.5% of patients studied at autopsy or during cardiac catheterization. Patients can present with a wide range of symptoms from asymptomatic to sudden death. Complications include angina, myocardial infarction, fistula formation, spontaneous rupture, and distal embolization as a result of thrombus formation within the aneurysm. Treatment options include surgical ligation with coronary artery bypass surgery and implantation of a covered stent. Coronary anomalies and nonatherosclerotic coronary artery diseases should be suspected when a young patient presents with a myocardial infarction. Additionally, coronary aneurysm or pseudoaneurysm should be considered in patients with connective tissue disorder or the suggestion of connective tissue disorder. These entities may present as masses radiographically or echocardiographically. A high clinical suspicion is required for appropriate diagnosis and treatment.