Unilateral pulmonary edema (UPE) is an unusual clinical condition occurring in left heart failure (LHF). Normally, cardiogenic UPE is more pronounced on the right side when no right pulmonary artery obstructive lesion exists. In contrast, we present a rare case of left-sided UPE due to ventricular septal rupture (VSR) complicated by acute myocardial infarction. Although the precise mechanism of unilateral presentation is not clear, such a left-sided unilateral manifestation is extremely rare in LHF. This is believed to be the first reported case of left-sided UPE with postinfarction VSR.