Introduction: Aneurysms of the extracranial internal artery (ICA) are rare and accountable for about 1% of all cerebral anerysms , it's an uncommon patology, reported in literature as individual case or small series. Aneurysm of extracranial carotid artery etiology is diverse and ranges from athrosclerosis, infection, fibromuscolar dysplasia, connettive tissue desease to traumatic or spontaneous dissection, patch pseudoaneurysm from prior repair. Rupture and thromboembolism are two major risk of aneurysm of ICA, wich may lead to acute ischaemic attacks and strokes.Case presentation: A 57-year-old woman without medical history, presented passing diplopia and distesthesia at right half face. Duplex ultrasound that revealed a saccular aneurysm of right. CT angiography confirmed the diagnosis. The first approach was endovascular, without results because a difficult signing of ICA downstream aneurysm. So was performed an oper surgical resection of the aneurysm, the ICA ends were bevelet to the appropriate lenght and anastomosed in an end to end fashion. Discussion:The available information on extracranial carotid artery aneurysm treatment in the litterature suffers greatly because of its rarity, from small cases series, missing data, publication bias. Both endovascular ans open surgery as well as medical treatment have been raccomended depending on desease location and comorbities.Conlcusion: Surgical repair can be safe and effective solution to treat extracranial ICA aneurysm, however the choice of treatment should be evaluated time by time, according to symptoms of patients and comorbities but, mostly, to the aneurysm conformation.