Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. It presents predominantly in infancy with features of myocardial ischemia or cardiac failure and may be mistaken for common pediatric conditions such as colic, reflux or bronchiolitis. With early surgical correction the prognosis is good. In this report we present unusual case of a 5-year-old female with an anomalous left coronary artery arising from the pulmonary artery (ALCAPA) presenting with chest pain,dyspnea and palpitation during physical exertion.Trans-thoracic echocardiography and coronary angiography revealed an anomalous origin of the left coronary artery with mitral regurgitation . She subsequently underwent successful surgical technique where the left internal thoracic(mammary) artery was used to revascularise the left main coronary artery which is considered as the first unique procedure in children. Excellent surgical results were obtained and the patient was discharged from the hospital without complaints.