We demonstrate the echocardiographic features of a rare case of very extensive left ventricular to coronary arterial connections (VCC) to both the right and left coronary arteries in a fetus and subsequent neonate with hypoplastic left heart syndrome (HLH). The right coronary artery, after receiving multiple VCC supplied the only antegrade ascending aortic flow. The left main coronary artery was very hypoplastic and the left anterior descending coronary artery was dilated and tortuous with multiple large VCC. The left circumflex coronary artery arose exclusively from its own VCC. To our knowledge this is the first such echocardiographic demonstration of HLH with extensive bilateral VCC and coronary artery stenosis and interruption.