We present a case of Takotsubo cardiomyopathy caused by Graves’ thyrotoxicosis in the setting of known moyamoya disease (MMD). MMD has been reported to be associated with Graves’ disease, and there are a handful of case reports citing Graves’ thyrotoxicosis as the cause of takotsubo cardiomyopathy.56-year-old female with medical history of moyamoya disease with prior cerebrovascular accidents, and remote hyperthyroidism following childbirth that required treatment presented with complaints of throat discomfort similar to a prior myocardial infarction.