The clinical, echocardiographic, and pathologic features of a discrete calcified left ventricular thrombus are presented in a young adult man with a two-year history of transient visual field defects leading to eventual loss of vision in his left eye. M-mode and cross-sectional echocardiographic studies suggested a large mass extending across the left ventricle. These findings were confirmed at surgery when a calcified mass pathologically consistent with a calcified thrombus was removed. The pertinent literature on the echocardiographic diagnosis of left ventricular thrombi is reviewed.