Right ventricular wall dissection following ventricular septal rupture related to inferior myocardial infarction has been reported in a few cases. In most of the cases, right ventricular wall dissection was diagnosed in postmortem studies. Herein, we present a 68-year-old man who had a ventricular septal rupture with right ventricular wall dissection after inferior myocardial infarction. Early recognition of this complication with bedside transthoracic echocardiography and prompt surgical repair are key to achieving survival in these patients.