A saccular aneurysm on the apical surface of the left ventricle was demonstrated by two-dimensional echocardiogram in a two-chamber apical long-axis view. It seemed that the aneurysmal orifice which communicated aneurysm with the left ventricular cavity consisted of narrow, and high-density echo suggestive of thrombotic material. A discontinuity of the left ventricular endocardial echo was demonstrated at the site of the aneurysmal orifice. Therefore we were able to confirm the presence of a left ventricular pseudoaneurysm echocardiographically. But it was confirmed in the autopsy that the orifice of the aneurysm was narrow due to large calcified thrombus, and the junction of the aneurysm and left ventricular wall showed no interruption of myocardial tissue in our case. Therefore we judged that the true aneurysm was divided into two chambers by the large calcified thrombus and failed to recognize the one as a pseudoaneurysm.