Inferior ST-elevation myocardial infarction (STEMI) secondary to an aortic mass presents a rare and complex clinical scenario requiring heightened diagnostic vigilance. We report a case of a 22-year-old female presenting with recurrent chest pain, ultimately diagnosed with inferior STEMI secondary to an aortic mass compressing the coronary arteries. Advanced imaging modalities and a multidisciplinary approach were crucial for accurate diagnosis and optimal management. Surgical intervention to address the aortic mass, coupled with myocardial reperfusion strategies, led to favourable outcomes. This case underscores the importance of recognizing the intricate interplay between cardiac and vascular pathologies to guide tailored therapeutic interventions and optimize patient care.