Echocardiography is the mainstay imaging technique for detecting infective endocarditis vegetations but may struggle to detect and characterise complicating features. There is increasing interest in the use of multidetector computed tomography (MDCT) as an adjunct to echocardiography, especially where there is concern for abscess or pseudoaneurysm formation. We present the case of a 70-year-old male with bio-prosthetic aortic valve endocarditis complicated by a large infected left ventricular outflow tract pseudoaneurysm which was diagnosed using MDCT angiography. Radiologists and clinicians should be aware of the emerging role of MDCT in this setting in order to advise and direct an appropriate imaging strategy.