Herein we describe a case of marantic endocarditis (non-bacterial thrombotic endocarditis) that presented with coronary, cerebral and peripheral emboli, fevers and malaise, and negative blood cultures. The ‘kissing lesions’ on all three leaflets of the aortic valve were bulky and friable. After aortic valve surgery, an acute abdomen prompted laparoscopy which demonstrated disseminated adenocarcinoma. We discuss the clinical presentation of this rare condition and the importance of considering marantic endocarditis secondary to malignancy as a differential diagnosis for culture negative endocarditis.