Intracardiac extension of pulmonary aspergillosis is uncommon. We report a case of a patient with chronic necrotizing pulmonary aspergillosis without clinical evidence of cardiac disease in whom transthoracic echocardiography revealed an intracardiac mass. A subsequent transesophageal examination clearly defined a large and complex mass in the left atrium and pulmonary artery. Autopsy performed after cardiopulmonary arrest confirmed the presence of direct cardiac invasion of pulmonary aspergillosis with widespread embolization. This case illustrates the possibility of direct intracardiac extension of pulmonary aspergillosis and the value of transesophageal echocardiography in establishing the diagnosis.