A thrombosed LV aneurysm simulating an Intra-myocardial dissection hematoma (IDH) is a rarely reported condition. We describe a rare case of a 52-year-old man suffering from a thrombosed LV aneurysm, who was initially diagnosed as an IDH by conventional echocardiography. Finally, the patient was diagnosed with thrombosed LV aneurysm through multimodal imaging. We discuss the diagnostic process and surgery of the thrombosed LV aneurysm.