Congenital communications between the coronary artery and cardiac chambers are rare. The majority of cases present in adulthood. We report a patient with a coronary cameral fistula in which surgical closure of the fistula was performed at 10 weeks of age at a weight of 3.9 kg. We recommend early closure of coronary cameral fistula in symptomatic patients. Low weight or young age at presentation should not be a limiting factor.