Background: sinus of valsalva aneurysm is a rare congenital anomaly and usually presents in adolescence to early adulthood. Manifestations are varied, ranging from asymptomatic murmur to sudden death. Case report: an elderly male presented with chest pain and machinery murmur, which was confirmed as ruptured sinus of valsalva aneurysm on echocardiogram. Emergency surgical repair led to a successful outcome. Discussion: review of the literature revealed that this patient is the oldest reported case. Urgent echocardiography and surgical advice are essential. This condition is potentially treatable even in the older age group and the prognosis is good after surgical repair.