Endomyocardial fibrosis (EMF) is the most common restrictive cardiomyopathy worldwide. However, its etiology and pathogenesis remain unclear. Epidemiology data are limited but the highest prevalence has been reported in tropical region specifically sub-Saharan Africa (1). EMF is characterized by apical filling with fibrotic tissue in one or both ventricles, often associated with thrombus and calcification. Most often it extends to the posterior leaflet of the mitral valve, papillary muscle or chordae tendineae, causing atrioventricular valve dysfunction. Transthoracic echocardiography (TTE) is the first-line modality for assessment, but MRI has emerged as a more accurate tool for the tissue characterization of this disease(2).