Abstract Spontaneous coronary artery dissection (SCAD) is considered one of the rare causes of acute coronary syndrome. It’s been related to many predisposing factors mostly connective tissue disorders, fibromuscular dysplasia in particular, traumatic and atherosclerosis as the most common etiologic factor. It occurs predominantly more in women & is been associated with stress & pregnancy. Here we present a rare case of coronary artery dissection extending to left main coronary artery in 33 years old women post elective cesarean section.