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We report a case of a 53-year-old male patient with typical angina and dyspnea with moderate exertion due to extrinsic compression of the left main coronary artery (LMCA) by a pulmonary artery aneurysm. Coronary angiography demonstrated 90% stenosis of the LMCA ostium. Percutaneous coronary intervention was successfully performed with implantation of a 6.0 mm × 12 mm bare-metal stent guided by intravascular ultrasound (IVUS). He remained asymptomatic at three-years evaluation, and angiographic and IVUS follow-up showed no significant in-stent neointimal hyperplasia or luminal loss, with excellent apposition and covering of stent struts and minimal luminal area 23.3 mm 2 as measured by IVUS.