A case of Dressler’s syndrome with cardiac tamponade is presented. 19 days after an acute lateral myocardial infarction, the patient, 46 years old, was admitted the second time with a characteristic clinical picture of cardiac tamponade. The patient did not receive at any time during his admission an anticoagulant treatment. The clinical diagnosis was supported by fluoroscopic and echocardiographic findings. A pericardiocentesis performed immediately revealed a hemorrhagic pericardial fluid. After withdrawal of 60 ml, the patient’s clinical condition improved dramatically and this improvement continued further under treatment with corticosteroids. At the best of our knowledge this is the second case in the literature of Dressler’s syndrome with cardiac tamponade and hemorrhagic fluid in a patient not treated with anticoagulants.