We experienced a rare case of post-infarct left ventricular aneurysm (LVA) and ventricular septal perforation (VSP). An 83-year-old woman was treated for acute cardiac insufficiency. Three weeks later after hospitalization, she had sudden cardiorespiratory failure and was diagnosed with VSP and LVA. She underwent emergency heart surgery. After establishing extracorporeal circulation, the LVA was excised longitudinally from the left side of the left anterior descending branch. Endoventricular patch plasty (Dor procedure) was performed to exclude the ventricular aneurysm, and the VSP was closed using Dacron patch. After surgery, echocardiography found no residual shunts and exclusion of the LVA. The patient underwent successful surgical treatment of VSP and LVA.