We describe a young man with Behçet's disease who presented with acute coronary insufficiency: emergency coronary arteriography revealed 2 coronary aneurysms and a left anterior descending (LAD) artery stenosis which was successfully dilated. The reduction of the coronary stenosis by balloon angioplasty induced immediate relief of chest pain and decrease of ST segment elevation, and was probably responsible for the satisfactory evolution, with limited myocardial infarction on the ECG and no akinetic segment on the left ventricular angiogram 3 weeks after the acute event. Cardiac surgery was performed to avoid possible relapse or aneurysmal rupture with hemopericardium. Surgery confirmed the destructive arterial lesion of Behçet's disease with false aneurysms of the LAD and left circumflex arteries.