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A mid 30’s-year-old man presented to the medical emergency department with complaints of sudden onset weakness of left upper and lower extremity. Brain magnetic resonance imaging (MRI) revealed decreased blood flow in the right middle cerebral artery (Figure 1A arrow) and findings of acute cerebral infarction confined to the artery perfusion area (Figure 1B). Echocardiography performed to search for a thrombus source showed prominent trabeculations in the inferolateral wall and apex of the left ventricle with reduced contractility. Furthermore, thrombus was detected at cardiac apex within the trabeculations (Figure 1C* and video). Cardiac MRI demonstrated thinned left ventricular myocardium with extensive hypertrabeculation (Figure 1D). Based on these findings, this patient was diagnosed with non-compaction of ventricular myocardium with left ventricular thrombus. Non-compaction of ventricular myocardium is an embryological disorder of endocardial trabeculation and can cause heart failure and thromboembolism [1,2]. Lifelong anticoagulation is indicated in patients with high risk of thromboembolism.