Lipomatous metaplasia is characterized by substitution of muscle fibers with adipose tissue in the context of a myocardial scar. Cardiac magnetic resonance is an accurate cardiac imaging technique with high tissue spatial resolution that can easily characterize scar tissue, adipose tissue and lipomatous metaplasia. We report a case of lipomatous metaplasia in a 68-year-old man with a 14-year history of anterior myocardial infarction admitted to our cardiac department for dyspnea and palpitations.