Aortico-left ventricular tunnel is a rare paravalvular communication between the aorta and the left ventricle resulting in severe aortic regurgitation. It originates most frequently just superior to the right sinus of Valsalva and enters the left ventricle just inferior to the right aortic valve cusp traversing the infundibular or perimembranous ventricular septum. We report our experience with this lesion presenting in a neonate on the first day of life and describe its clinical presentation, noninvasive diagnosis, and surgical management.