Extracranial aneurysms are a rare presentation accounting for only less than 5% of all peripheral artery
aneurysms. The left common carotid artery aneurysm is considered even rarer. We present a case of a 46-year-old gentleman who presented to casualty unit with a neck mass, stridor and acute respiratory distress. Prior to this admission patient was being investigated for Takayasu arteritis (TA). Patient was subsequently intubated due to respiratory compromise. A CT angiography of the thorax was done
showed a proximal left common carotid artery aneurysm with contained leakage of aneurysm with
severe compression of the trachea. Patient was subsequently transferred to the vascular team in National Heart Institute for further management.