Acute myeloid leukemia (AML) is a hematologic malignancy that, through clonal transformation, results in abnormal proliferation and accumulation of immature myeloid cells in the bone marrow and blood. It is the most common type of acute leukemia in adults; however, extramedullary relapse is rare, and clinically significant metastasis to the heart with multiple presentations is even more infrequent. We present a case of a patient with AML, who, after successful treatment and remission, was found to have extramedullary metastasis in the form of one pericardial and two intracardiac masses, as well as a large pericardial effusion and conduction abnormalities.