A 72-year-old man presented with worsening shortness of breath and a systolic murmur. Transthoracic and transoesophageal echocardiograms revealed a huge mass (70 x 30 mm) obliterating the right ventricular outflow tract, with a peak transpulmonary gradient of 128 mmHg. Pathological examination confirmed the mass to be a primary cardiac rhabdomyosarcoma originating from the pulmonary valve.