The authors present a rare case of anomalous origin of circumflex coronary artery from the right pulmonary artery combined with large patent arterial duct in a 2-year-old child. Anomalous coronary artery was diagnosed after CT angiography performed for suspected coarctation of the aorta and patent arterial duct. Surgical correction included reimplantation of anomalous coronary artery into aortic root and ligation of patent arterial duct. Excellent immediate and long-term outcomes were obtained.