Background: Kounis syndrome is the occurrence of acute coronary syndrome precipitated by an allergic reaction in the presence or absence of underlying coronary artery disease. The syndrome is explained by the effect of released inflammatory mediators on the coronary arteries and platelets. Case summary: We report an uncommon case of Kounis syndrome Type II in a 65-year-old man 24 h after being bitten by a hymenoptera. Clinical context, electrocardiogram, coronary angiography, and enhanced cardiac magnetic resonance imaging (MRI) imaging modality are presented. Discussion: Awareness and understanding of this syndrome is essential for starting early and appropriate therapy, thereby preventing life-threatening events. Accordingly, we highlight the importance of enhanced cardiac MRI to complete the assessment of this entity.