Background : The incidence of fistula formation complicating infective endocarditis has been estimated to about 1% of all case of infective endocarditis. Fistulization of perivalvular abscesses in infective endocarditis was found in 6% of cases and it was an independent predictive factor for early operative mortality. In infective endocarditis, the spread of infection from its usual site on a cardiac valve to the surrounding perivalvular structures often occurs with aortic valve involvement. Case: We report a case of the mitral-aortic intervalvular fistulas complicating infective endocarditis. 56-year-old female previously treated because of bacterial meningitis, visited to our hospital due to dyspnea and chest discomfort. Transesophageal echocardiography showed aortic valvular vegetation with pseudoaneurysm and fistula from subaortic area to left atrium via pseudoaneurysm. She also had severe aortic valve regurgitation and moderate mitral regurgitation. We planned the operation of aortic valve replacement and intracardic fistula closure using patch. During operation, anterior leaflet of mitral valve was found to be perforated and mitral valve replacement was also performed. Now she has a routine out patient follow-up.