Emerging infections caused by vancomycin-intermediate Staphylococcus aureus (VISA) isolates are more likely to be associated with treatment failures than infections caused by other types of S. aureus. We present a case of pacemaker lead infective endocarditis caused by a non-daptomycin-susceptible strain of VISA. After 8 weeks of parenteral telavancin therapy, the patient achieved microbiological and clinical cure. Copyright © 2010, American Society for Microbiology. All Rights Reserved.