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Coronary artery anomalies are uncommon. They are usually benign and incidentally detected during angiography. However, a thorough knowledge of anatomy and hemodynamic significance helps in risk stratification and choosing an appropriate treatment modality. In this report, we describe a rare combination of coronary anomaly consisting of dual LAD(left anterior descending)-Type IV and anomalous LCX(left circumflex) originating from right sinus during primary angioplasty of RCA(right coronary artery). The course of these arteries was further delineated with computed tomography coronary angiography(CT CAG).