We report an operative case of the anomalous origin of the left coronary artery from the right pulmonary artery with aortic intramural course. This particular anatomy was clearly identified with a preoperative angiogram. The restoration of the two-coronary system was accomplished by unroofing the intramural segment into the left sinus of Valsalva with encouraging midterm results. The details of this anatomical correction are described with a review of the literature.