Sinus of Valsalva aneurysm (SVA) is a relatively rare organic cardiac anomality. Here, we report a case of a ruptured SVA with tricuspid valve prolapse (TVP) and severe tricuspid regurgitation (TR). A 33-years-old man was admitted to our hospital who presented chest tightness after activity. Coronary sinus aneurysm(1.2cm*1.0cm) and tricuspid systolic prolapsed into the right atrium was detected by echocardiography. And later the patient was confirmed by surgery and pathology that the congenital aortic sinus aneurysm ruptured. Echocardiography played a vital role in the diagnosis and differential diagnosis of this case of RSVA and even the follow-up preoperative preparation.