The case considered concerns as 57 year-old patient who was submitted for heart tests because of a slight diastolic aortic murmur and hypertension. Echocardiographic investigation diagnosed an aneurysm of the sinus of Valsalva. The patient underwent a surgical intervention to reconstruct, on a dacron piece, the right sinus of Valsalva from which the aneurysmal cavity originated, retaining the aortic valve. After a short description of the etiology and the natural history of this condition we explain the importance of echocardiographic tests for the diagnosis and post-operative follow-up of these patients who run a high risk of severe and often lethal complications.