Neonatal myocardial infarction is a rare disorder. It occurs in association with congenital heart disease or coronary artery abnormalities. In the absence of structural heart disease, perinatal asphyxia and coronary artery thromboembolism have been reported as common etiologies. Whether the Coxsackie B viral group has a causal role in adult myocardial infarction remains controversial. We report herein a case of neonatal myocardial infarction without known congenital heart disease, in whom perinatal Coxsackie B viral infection was suspected to be the underlying cause. However, definite evidence indicating a causal relationship between neonatal myocardial infarction and Coxsackie B viral infection was lacking in this case.