Background: Aneurysms of the extracranial carotid artery are a rare entity and correspond to <1% of all arterial aneurysms.
Case Summary: A 58-year-old male with known human immunodeficiency virus (HIV) infection presented in the emergency department with a massive cervical tumour on the right side of the neck and a severe occipital pain. Contrast computed tomography demonstrated a pseudoaneurysm of the proximal right internal carotid artery (ICA).