Hoarding behavior associated with focal brain injury is rarely reported. The authors report a 46-year-old man with pathologic collecting behavior after a left orbitofrontal and caudate injury from an aneurysmal rupture of anterior communicating artery. His hoarding, an impulse control disorder or an ego-syntonic compulsion, was restricted to one specific item (toy bullet). Treatments with sertraline or fluoxetine were not effective for the hoarding.