Anomalous origin of the LCA from the right sinus of Valsalva (AOLCA) was reported in a 52-year-old male non-competitive master cyclist, with a history of stenting of RCA. Three-dimensional cCTA reconstructions (volume rendering) of the heart (A and B) and the coronary tree (C) clearly showed that the LCA originated from the ostium of RCA and an ‘inter-arterial’ segment of the proximal portion of the vessel between the aortic root and pulmonary trunk. The multiplanar reconstruction (D) highlighted close adherence of the proximal LCA to the aortic wall (arrowheads), suggesting an ‘intra-mural’ path. LCA, left coronary artery; RCA, right coronary artery; cCTA, coronary computed tomography angiography.