| Summary: | Giant cavernous carotid aneurysms are rare pathologic entities that are typically benign and are considered less life-threatening due to the low risk of rupture of bleeding. They present with clinical features usually due to localized mass effects on adjacent neural structures, mainly the III, IV, V, and VI cranial nerves. There are various treatment options, including occlusion of the feeding vessel, immediate surgery on the aneurysm, bypass procedures, and use of endovascular devices. We present a case of a 36-year-old male presented to the emergency department with 5 days history of right retro-orbital pain and diplopia. The patient's imaging workup revealed a right giant cavernous carotid aneurysm. Along with the conventional symptoms, physical examination revealed sinus bradycardia. Internal carotid artery occlusion was performed, and his symptoms gradually resolved.
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