Dear Editor We report here a case of a left atrial myxoma which presented with recurrent syncope. A 45 year old woman presented with dyspnoea Class IIb. There was a history of Orthopnoea and Paroxysmal Nocturnal Dyspnoea, Low Grade Fever and Weight Loss. She gave history of Syncope specially with change of position and posture. On EXAMINATION she was nonmotensive with tachycardia. She had anemia with clubbing. On auscultation first and second heart sounds were normal. She had a middiastolic rumble. Diagnosis of mitral valvular heart disease with or without endocarditis was thought. Her investigations showed onxray chest cardiomegaly with prominent Upper Lobar Pulmonary Veins, Haemogram was Normal except raised ESR. ECG showed Incomplete RBBB. ECHO showed a large mass arising from inter atrial septum moving to and fro across mitral valve. Patient was subjected to surgery with removal of mass, which on histopathology proved to be Myxoma. This case highlights the importance of ECHO in a case of syncope. Echocardiogram showing myxoma in left atrium during systole Myxoma prolapsing into left ventricle during diastole