Idiopathic hypereosinophilic syndrome represents a heterogenous group of leukoproliferative disorders with hypereosinophilia of an unknown etiology resulting in multiorgan dysfunction. The disease can involve any organ but commonly involves heart, nervous system, skin, and gastrointestinal system. Steroids and chemotherapy agents remain the mainstay of the treatment to suppress organ damage and eradicate eosinophilia. We are presenting an interesting patient of idiopathic hypereosinophilic syndrome with cardiac involvement who was refractory to many chemotherapeutic drugs including imatinib but had an excellent response to etoposide. Although the mechanism by which etoposide works in this disease is not well understood, it has been tried in the past with success. The patient is off therapy for the past 24 months with stable eosinophil count.