Acute bacterial endocarditis is a rare but fatal complication of thermal injury. The incidence of acute bacterial endocarditis after burn is between 0.6-1.3% and mortality rate is 95%. We report a patient who developed aortic valve infection after thermal injury and treated successfully. A 57 year old man was well until he suffered a burn injury affecting 35% of body surface area (predominantly face, chest and arms). He had initially required care on intensive care unit for a prolonged period. After multiple operations for skin grafting and a period of circulatory instability his condition improved. Three months later after a urinary catheter was inserted he developed a temperature of 38 C and urinary infection was diagnosed. He was treated with antibiotics but had persistent tachycardia and fever. Three days later he became hypotensive. Blood cultures were taken and have been positive for pseudomonas species. Because of difficulties for sternotomy for aortic valve replacement and the burns, it was decided to continue with a period of conservative treatment to optimize him prior to proceeding with his surgery. After treatment with appropriate antibiotics the patient’s aortic valve replaced with Perimount valve, and post-operative course was uneventful. We acknowledge that acute bacterial endocarditis after burn has a very high mortality risk but it can be treated successfully after patient’s heamodynamics become stabilized.