Although various forms of Aspergillus disease are not uncommonly encountered in lung transplant recipients, Aspergillus endocarditis has never been reported. A case of Aspergillus endocarditis in a lung transplant recipient is presented here and is among 10 total cases reported in the solid organ transplant literature. This case is used to compare and contrast the clinical features of all of the reported cases with special emphasis on common characteristics that may aid in future case diagnoses and treatment. Pre-mortem diagnosis is difficult. Rapid diagnosis and combined medical and surgical therapy are essential for an optimal outcome.