CK-MB elevation is considered to be one of the specific and sensitive indicators of myocardial infarction in a patient with chest pain. But when faced with isolated elevation of CK-MB without any increase in Total CK and Troponin levels, multiple other causes should be suspected. Isolated CK-MB elevation  usually points away from a myocardial source as a cause of CK-MB elevation and there by avoiding unnecessary investigations and interventions. We present a case where CK-MB elevation was due to non myocardial infarction cause. We also offer a review of current literature which every astute physician should be aware of.