To our knowledge, this is the first report of primary percutaneous coronary intervention in a patient with a superdominant left circumflex artery, in which the entire right coronary artery myocardium territory is provided by the left circumflex. Coronary angiographic images of our 80-year-old male patient illustrate this anomaly. Single coronary arteries are among the most rare anatomic coronary anomalies, and the absence of right coronary artery ostium has been described as the rarest of these anomalies. Coronary events in such cases can be catastrophic due to the large amount of myocardium at risk.