We describe a case of bilateral coronary artery fistula originating from the left anterior descending and right coronary arteries which showed multiple saccular aneurysm formation. Although saccular aneurysm formation in patients with bilateral coronary artery fistula is extremely rare, only 3 similar cases having been reported before, it shows two distinctive features upon coronary angiography: multiplicity and origin in the left fistulous coronary artery.