Myocardial abscess is a severe and life-threatening infectious complication that is commonly but not exclusively associated with infective endocarditis. It may also be developed in necrotic myocardial tissue, post trauma, in septic burn patients, in transplanted heart, in ventricular aneurysm and post angioplasty. Patients on hemodialysis are prone to bacteremia, and infectious complications occur in 48-73% of cases. Myocardial abscess is a rare complication of an infected arteriovenous fistula. We present an autopsy report of a hemodialysis patient who had an arteriovenous fistula with a polytetrafluoroethylene graft where a local infection developed. The patient presented with fever and toxemia. On post-admission day 2, he unexpectedly suffered sudden cardiopulmonary arrest and died. The autopsy revealed a myocardial abscess, near a branch of the left coronary artery, with septic embolism.