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The extracranial carotid artery aneurysm (ECAA) constitutes <1% of all arterial aneurysms and 4% of peripheral arterial aneurysms. Atherosclerosis (46–70%) is the most common cause of etiology. When these aneurysms are not treated, complications such as risk of rupture, stroke and death due to thromboembolism have been reported. In this case, we aimed to present a case of bilateral and giant ECAA as the cause of acute infarction.