Intramyocardial dissecting haematoma (IDH) is a uncommon complication of myocardial infarction, with very few case reported till date . Before the era of non-invasive imaging techniques, the diagnosis of IDH was made at autopsy. Commonly IDH may involve the ventricles and or the IVS. We are discussing a case of acute anterolateral myocardial infarction with intramyocardial dissection with haematoma and the use of echocardiography in the management of this rare complication. Using bedside echo continuous monitoring of the dissection, progression of haematoma can be evaluated. The differential echogenicty of fluid and clotted blood can be compared easily with the surrounding myocardial structures, making it easier to constantly monitor the evolution of this complication.