Aim: The purpose of this study was to analyze the aetiology, the mode of presentation; surgical management of a series of extracranial internal carotid artery aneurysms (EICAA). 
Patients & methods: This study includes 10 patients 8 men & 2 females with aneurysms involving the extracranial internal carotid artery presenting to Kasr El-Eini hospital during the period from January 2000 to December 2003. 
Results: The etiology was trauma in 4 patients (40%), , atherosclerosis in 4 patients (40%), Behcet's disease in 1(10%) patient & mycotic aneurysm in 1 patient (10%). As regards the management interposition grafting was applied in 8 (80%) of the 10 cases saphenous interposition graft was applied in 5 cases (50%) and in 3 (30%) cases polytetrafluoroethylene (PTFE) graft was used. Two cases were treated by ligation (20%). Clinical results showed minimal complications in two patients one with haematoma, & other with hypoglossal nerve affection. Follow up Duplex was done for 8 cases within the 2 years following surgery and proved no stenosis or occlusion in the repaired artery. 
Conclusion: EICAA are rare and have variable causes. Safety and long-term reliability of appropriate surgical approach warrant broad surgical indications, because of the risk of embolization and rupture of these aneurysms.