Left ventricular free wall rupture is a well-recognized complication of myocardial infarction and is a frequent cause of death. Immediate surgical repair is the treatment of choice and many different surgical approaches have been reported. We describe an off-pump sutureless technique with the use of a glutaraldehyde-treated bovine pericardial patch and biological glue (N-butyl-2-cyanoacrylate) in a 60-year-old male patient with echocardiographic evidence of cardiac tamponade and a free wall rupture site on the lateral wall. The recovery was uneventful and the patient was discharged from the hospital on the eleventh postoperative day. At 3 months, he remained well and without any symptoms.