Pseudoaneurysms of the intracranial internal carotid artery may occur in the setting of carotid artery dehiscence, due to trauma, invasive tumors, or as a complication of surgery. The rare surgical complication of carotid artery laceration in the petrous segment may occur during myringotomy procedures, middle ear operations, or petrous temporal bone surgery. We report a 28-year-old female patient, a case of internal carotid artery pseudoaneurysm as a complication of middle ear surgery. On her follow-up, computed tomography of the temporal bone demonstrated a dehiscent carotid artery, and a Pseudoaneurysm involving the left petrous internal carotid artery was found in the cerebral angiography. She was managed by endovascular means. (C) 2009 Elsevier Inc. All rights reserved.