An aneurysm of the extracranial internal carotid artery is a rare disease. We report of a patient with this disease who complained of dysphagia and dyspnea, requiring tracheostomy. The patient was a 78-year-old female, who had a left pharyngeal large mass. The patient presented with right hemiplegia and motor aphasia due to a brain infarction, and left recurrent laryngeal nerve paralysis and Homer's symptom caused by a large mass that had recently appeared. After therapeutic embolization of the internal carotid artery, we performed aneurysmal resection without arterial reconstruction.