Definitive diagnosis of an anomalous coronary artery from the main pulmonary artery (ALCAPA) can be difficult.  Cardiac computed tomography (cardiac CT) has the ability to safely, cheaply and non-invasively allow direct visualization of the anomalous coronary connection and can demonstrate the systemic-to-venous flow which underlies the coronary steal phenomenon.  Here we present the first case of ALCAPA syndrome diagnosed with cardiac CT in Trinidad and Tobago.