Coronary cameral fistula is a rare entity characterized by an abnormal communication between coronary artery and a cardiac chamber. It is congenital and asymptomatic in the majority of patients. A 29-year-old male patient presented with fever and dyspnea for eight months. A coronary cameral fistula arising from the right coronary artery to the right atrium complicating with aortic valve endocarditis was detected on computed tomography angiography. The rarity of the condition and the nuanced complication led to very individualized course of treatment which was optimal for this patient.