Mini‐Abstract In this report, we present the case of an 85‐year‐old patient with a recent history of an infective endocarditis (IE) referred to our hospital for severe mitral regurgitation. After closer observation, echocardiography showed a large pseudoaneurysm in the posterior mitral annulus opening into the left ventricle. Anatomical assessment by 2D and 3D transesophageal echocardiogram (TEE) was essential for a detailed morphologic characterization and surgical procedure delineation. This type of IE mitral periannular extension is uncommon and early surgical intervention is critical, however the outcome is still often adverse.