An arteriovenous malformation (AVM) is an anomalous connection between arteries and veins, which bypasses the capillaries, thus allowing arteriovenous shunting. While known to commonly occur in the central nervous and pulmonary systems they are less common elsewhere. This location in the epicardial fat (supplied by the left inferior phrenic artery and draining into the inferior left pulmonary vein) appears to be rare with no case reports in the literature. This case demonstrates these can occur anywhere in the body.