Bland – White – Garland syndrome (or ALCAPA) is a rare coronary anomaly including anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). It occurs in 0,2-0,5% of all congenital cardiac malformations. Although it has high mortality rate of 90% within the newborn children. Ca. 10–15% of patients reach adulthood. In most cases the existence of extensive coronary collaterals is increasing their chances to survive [5,6,7]. Usually adult patients with ALCAPA are asymptomatic. We present a case of an 18 years-old patient with Bland-White-Syndrome, who suffered an episode of non – ST segement elevation myocardial infarction and successfully treated with cardiac surgery. JRCD 2015; 2 (2): 26–29