The Eustachian valve is an embryological remnant of the valve of the inferior vena cava. It may be prominent in some individuals, but the echocardiographic appearance of a divided right atrium (RA) as a result of a large Eustachian valve is rare. Sometimes it presents a problem of differential diagnosis with other embryonic remnants of the right atrium, such as the Chiari network. It may be complicated by thrombosis or infective endocarditis. Cardiac imaging plays an important role in diagnosis. The aim of this review is to discuss a rare form of Eustachian valve complicated by thrombosis.