Right-sided prepectoral implantation of an ICD is performed in unusual circumstances only, like in patients with abnormal venous drainage and preexisting left-sided devices. This case report describes a 42-year-old man who had undergone previous right pneumonectomy and who required ICD implantation for symptomatic inducible nonsuppressable hemodynamically unstable ventricular tachycardia. To avoid the small but real possibility of inadvertent iatrogenic left-sided pneumothorax in a patient with previous right pneumonectomy, a dual chamber ICD with an active can was implanted in the right prepectoral position.