The authors report a case of laryngeal ulceration due to cytomegalovirus occurring in a 60-year-old man one month after heart transplant. The recipient was initially CMV seronegative and the donor positive. No preventive treatment was administered. One month after the transplantation, search for CMV in blood and urine became positive and a seroconversion occurred. Laryngeal biopsy showed an inflammatory reaction with cells containing atypical inclusions and positivities with anti-CMV antibody. Usual intranuclear eosinophilic inclusions of classic CMV infection were absent. The authors stress the unusual site of the lesions in this primo-infection and the atypical aspect of the inclusions. Such atypical inclusions which have already been reported in immunosuppressed people make the diagnosis more difficult.