Central venous pressure(CVP) catheter has become regarded as necessary in the care of the critically ill patients, long time operation and the anesthesia that massive bleeding is anticipated. Exact placement of CVP catheter tip is essential for prevention of complications due to malposition. The correct location of CVP catheter should always be ensured after catheterization as soon as possible. Acute cardiac tamponade is the most serious complication associated with CVP catheter tip malposition that may follow perforation of heart or pericardium. In 54-year old female patient, a catheter that was introduced through the left internal jugular vein entered left pericardiacophrenic vein. We experienced a case of cardiac tamponade caused by malposition of CVP catheter tip after 12hours of left internal jugular catheterization.