A case is presented of a 16-month-old white boy with a communication or tunnel between the right sinus of Valsalva and the outflow tract of the left ventricle. The presence of a murmur at birth and the subsequent clinical course suggest that the tunnel was congenital. The physical, electrocardiographic, phonocardiographic, and aortographic findings were quite similar to those of “aortico-left ventricular tunnel” as described by Levy et al.1The tunnel was occluded surgically, but failure to appreciate the presence of severe aortic stenosis contributed to a fatal outcome.Postmortem study was carried out, and the relationship of the findings of aortico-left ventricular tunnel to aneurysm of the sinuses of Valsalva and the Marfan syndrome is briefly discussed.