The authors report the first case in the literature of a post-infarction left ventricular (LV) aneurysm operated in a black African man of 31 years. The episode of infarction had been ignored, and the patient presented a posterior LV aneurysm with moderate mitral insufficiency and heart failure. The diagnosis was made by a cineangiogram in the LV and a coronary angiogram showing a total obliteration of the right coronary. The patient underwent a resection of the aneurysm with closure of the LV-aneurysm communication. Six months after surgery, the patient was asymptomatic and the size of the heart had decreased. With regard to this unique case, the authors discuss the literature on LV aneurysms in African, and on coronary atherosclerosis in Africa. They discuss also the surgical indication in case of post-infarction LV aneurysm.