Chronic thromboembolic pulmonary hypertension (CTEPH) is a sub-category of pulmonary hypertension that is unique from other forms of pulmonary hypertension with regards to its pathogenesis, patient characteristics and management. By definition, CTEPH is precapillary hypertension with a minimum of one segmental perfusion abnormality on scintigraphy or a CT pulmonary angiogram having typical findings of CTEPH. Despite advancement in awareness, diagnosis and treatment of CTEPH, its prevalence has remained a question of concern in the field of medicine majorly contributed by its clinical presentation that mimics common cardiorespiratory diseases. This has largely been contributed by misdiagnosis and under-reporting of the incidence. Available data suggest an incidence of 0.56% for early diagnosis and 3% for late diagnosis/survivors. The commonest risk factors associated with CTEPH include unprovoked pulmonary embolism, recurrent pulmonary embolism and antiphospholipid syndrome. In this case report, we present a 24yr old female who presented to our outpatient clinic with features of heart failure and deep venous thrombosis initially being followed up for heart failure. The only clue towards CTEPH was the chronic leg swelling that was more pronounced on the left side otherwise a systemic inquiry was non-contributory. A Doppler ultrasound of the left lower limb demonstrated chronic deep venous thrombosis involving the femoral system of veins. Consistent with CTEPH was an echocardiogram that showed tricuspid regurgitation and elevated pulmonary pressures whereas a CT Pulmonary angiogram showed a dilated pulmonary artery trunk, dilated right ventricle and atrium, and pulmonary oligaemia.