Echocardiography is a useful tool when there is concern for a possible cardiac source of systemic embolization. Determining the etiology of a cardiac mass with transthoracic and transesophageal echocardiography can assist in this challenging task. A patient’s clinical presentation and medical history along with the features identified on transthoracic and transesophageal echocardiography can be useful in narrowing a differential diagnosis. Often histopathology of embolic material or the mass itself may ultimately be required to arrive at the diagnosis. We present the case of an immunocompromised patient who presented with recurrent multiterritory strokes and was subsequently found to have a cardiac mass, seen on transesophageal echocardiography, of unclear etiology concerning for the source of embolic disease.