A 56-year-old Bangladeshi male with no prior medical history presented with an inferior wall ST-elevation myocardial infarction with Killip Class II (). The cardiopulmonary examination was normal and the total ischaemic time was 90 min. Baseline laboratory investigations showed hs-Troponin-i ≥100 ng/mL (Ref. range: 0.01–0.04 ng/mL). Urgent cardiac catheterization was performed which revealed the presence of an SCA arising from the right aortic sinus which quadfurcated into left anterior descending (LAD) coronary artery, first diagonal (D1), left circumflex coronary artery (LCx), and right coronary artery (RCA). Multiple atherosclerotic lesions were present with 70–90% stenosis in the distal LAD and a severely calcified 70–90% stenosis in the D1 with reference diameter of the vessel at this level less than 1.5 mm. About 70–90% stenosis was present in the proximal circumflex (LCx) and had a 90–99% stenosis in the first obtuse marginal (OM1). Proximal RCA had an acute occlusion (). The crux of the RCA had a bifurcation lesion with MEDINA (0,1,1) of 90–99% (, Video S1). Percutaneous coronary intervention (PCI) was performed on the RCA with the deployment of three stents. First, one stent was implanted into the proximal RCA and two stents were implanted at the level of crux of RCA with inverted TAP stenting strategy. Full anti-ischaemic treatment including dual antiplatelet therapy was initiated. After 48 h, repeated PCI of the first obtuse marginal (OM1) and proximal LCx were performed (, Video S2 and ). Post-PCI transthoracic echocardiography revealed preserved left ventricle systolic function with an ejection fraction of 55–60%. Mild hypokinesia of the entire inferior wall, inferior septum, and infero-lateral wall detected. We did coronary computed tomography to study the anatomy. Single coronary ostium arising from the right was confirmed. It was found to have three abnormal courses of coronary arteries. Only RCA had a normal course. LCx was found to have retro-aortic course, LAD coronary artery had pre-pulmonic course, and D1 had a sub-pulmonic (septal) course. There was no interarterial course found in this case (). The patient was discharged on the fourth day from admission. The post-PCI period was uneventful.