A 52-year-old man presented to our institution with a one year history of intermittent, progressive chest tightness with activity. He underwent stress test which was positive. Coronary angiography revealed a long segment myocardial bridge of the left anterior descending artery (LAD). Initially, he was trialed on maximal medical therapy, however, symptoms continued. As a result, he was brought to the operating room for unroofing of the myocardial bridge with excellent clinical and radiographic outcome. The diagnosis, medical, and surgical management of myocardial bridge is complicated. Long-term data surrounding best options for management is scarce.