Cardiac papillary fibroelastoma (CPF) is the most common valvular tumour of the heart and the second most common primary cardiac tumour. Fewer than 50 cases being reported in the literature [1]. As the advancement in 3D echocardiography, its diagnosis in living patient is become easy. The CPF could be found on valve leaflets, chordae tendineae, and both ventricles. We present an interesting case of the CPF originating from the posterior leaflet of the mitral valve confusing with vegetation or annular calcification. The patient underwent successful surgical removal of the PFE