Ventricular septal perforation( VSP) after acute myocardial infarction( MI) is a serious condition that requires surgical treatment. However, good outcome is not always obtained. The mortality rate of VSP is particularly high in cases whom emergency surgery is performed early in the course of the disease, and the timing of surgery is known to affect prognosis. In this case report, the patient assisted with intra-aortic balloon pump. VSP closure surgery (a modified David-Komeda technique) underwent 8 days after MI onset. Except for mild residual shunt, the patient experienced no adverse event during postoperative course and was discharged 30 days after the surgery. This case illustrated timing of surgery as well as adequate mechanical cardiopulmonary assistance and surgical technique is important.