Abstract Sinus of Valsalva aneurysm (SVA) is a life-threatening condition that should be intervention as an emergency. Unruptured SVA is usually asymptomatic, ruptured SVA (RSVA) presented diversity especially as cardiovascular problems. This case report describes a patient with acute hepatic injury caused by RSVA. RSVA caused elevated central venous pressure and decreased portal venous inflow. The purpose of this report is to illustrate the influence of RSVA on liver.