Carotid artery pseudoaneurysm is a rare complication of injury to the head and neck, which has been traditionally managed by an open surgical repair to avoid the occurrence of devastating cerebral strokes. Their treatment presents a challenge because of the risk of serious neurological events. This report presents a case of a stab penetrating injury to the left upper neck (Monson`s zone-III), which resulted in ipsilateral seventh and twelfth cranial nerve palsy and contra lateral hemiparesis, and false aneurysm of the internal carotid artery. After excision of the aneurysm, the internal carotid artery was ligated. The postoperative course was uneventful, and the patient remains free of symptoms.