Coexistence of both congenital and atherosclerotic coronary heart disease is rare. We report a 52-year-old man who had severe valvular pulmonic stenosis and significant atherosclerotic disease involving coronary, subclavian and renal arteries. This combination of congenital heart disease and atherosclerotic arterial disease is probably the first report in published English literature. He underwent successful staged percutaneous interventions, which included balloon pulmonic valvuloplasty and angioplasty and stenting of right renal, left subclavian and right coronary arteries. On follow-up at 8 months, a check angiogram revealed patent stents and insignificant gradient across pulmonic valve.