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Background: Epistaxis is a commonly managed emergency by the ENT specialty. Although successfully managed in most of the times, internal carotid artery (ICA) aneurysms are among the rare causes that require prompt diagnosis, management and interdisciplinary intervention for saving the patient’s life. Case presentation: We report the presentation and management of four cases of ICA pseudoaneurysm bleeds, out of which three of them were successfully managed with endovascular coiling by interventional neuroradiology. Conclusion: Endovascular coiling of the PA (pseudonaurysm) with preservation of patency of ICA is the preferred treatment option when possible. Being a new technique, studies are required to assess the long term complications and failure rate.