Primary cardiac tumours in children are rare. Despite the majority of these tumours being benign, they may cause blood flow obstruction, ventricular dysfunction, and life-threatening arrhythmias. We present a case of a 4-year-old boy with repeated presyncope episodes in whom we found a large left ventricular fibroma. Our case emphasises that surgical resection is safely feasible even with large fibromas, avoiding cardiac transplantation in childhood.