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Aortic sinus aneurysm is a rare congenital malformation. During the embryonic period, dysplasia occurs in the middle elastic fiber of the aortic sinus wall and insufficient fusion occurs in the aortic valve annulus. Long-term high blood pressure can damage these weak compositions, leading to possible rupture and dissection of sinus aneurysms under a certain extreme hypertension. We report a rare case of giant coronary sinus aneurysm with intimal tear and aortic dissection that was detected by using transthoracic and transesophageal echocardiography.