Coronary artery fistulae (CAF) are rare anomalies. Herein, we describe the use of intraoperative transesophageal echocardiography (TEE) in the diagnosis and management of CAF. A 3-year-old child diagnosed to have ostium secundum atrial septal defect (OS ASD) was posted for surgical closure under cardiopulmonary bypass (CPB). Post procedure TEE revealed a single continuous turbulent jet toward right atrium near the lateral wall of tricuspid region and was diagnosed as CAF communicating right coronary artery and right atrium. Surgical ligation of the CAF under CPB was done and the child was discharged postoperatively without complications. This case highlights the utility of intraoperative TEE in the diagnosis and management of CAF. How to cite this article Subash S, Shivaprasad BM, Jayant A, Puri GD. Incidentally Detected Coronary Artery Fistula Detected on Routine Perioperative Transesophageal Echocardiography. J Perioper Echocardiogr 2013;1(1):27-29.