We present the case of a 1.8-cm carotid saccular aneurysm dependent on the left internal carotid, limited to the proximal portion of the bifurcation in a 66-year-old male with a history of hypertension and diabetes mellitus, successfully managed with an open surgical technique. Extracranial aneurysms of the carotid artery are rare and may be caused by atherosclerosis, trauma, infection, or other factors. These aneurysms are characterized by an increase in the diameter of the carotid artery and may require treatment to prevent complications such as embolism or rupture. Treatment may include open surgery or endovascular techniques, and the choice of treatment depends on several factors, such as the location and size of the aneurysm. Medical management may also be considered in selected cases. Diagnosis is made through imaging tests such as duplex ultrasound, computed tomography, or magnetic resonance imaging. It is important to perform a careful evaluation to determine the best treatment option and prevent complications.