Echocardiographic findings in a patient with ventricular septal rupture and anterolateral wall aneurysm complicating myocardial infarction are presented. The findings were confirmed by cardiac catheterization and surgery. Using M-mode ultrasonocardiography one was able to demonstrate and localize the aneurysm as well as the ventricular septal defect which presented as an oblique interventricular communication appearing only during systole. Thus echocardiography supplemented the invasive examinations in exactly revealing the site of ventricular septal rupture. Other echocardiographic features of ventricular septal rupture were right ventricular dilatation, pathological septal motion and abnormal tricuspid valve motion as recently reported by other authors.