We report the case of a 20-year-old female splenectomised thalassaemia major patient with severe iron overload, who presented with life threatening sepsis associated with a liver abscess. Her clinical course was complicated with an intra cardiac thrombus. 2D echocardiogram and Contrast Enhanced Computed Tomography (CECT) chest revealed a large oscillating mass in right atrium extending from the left hepatic vein through the inferior vena cava. After a prolonged Intensive Care Unit (ICU) stay supported with antibiotics and anticoagulation she had a good clinical recovery with evidence of resolution of the intra cardiac thrombus.