We present a novel case of recurrent brain abscesses found to be the result of a silent congenital right-to-left extra-cardiac shunt, a persistent left superior vena cava (PLSVC) draining into the left atrium. The patient’s brain abscess was evacuated surgically, treated with antibiotics, and his shunt was subsequently repaired. The case suggests that attention should be paid to evaluation for shunt physiology allowing for bypass of the pulmonary circulation in those with recurrent brain abscesses.