A 55 year old woman presented to the emergency room in shock state, bleeding from the oral and nasal cavity. The patient was a known case of recurrent maxillary carcinoma performed radiation therapy 9 years ago. Digital subtraction angiography revealed active extravasation from the cavernous portion of left internal carotid artery. Emergent parent artery occlusion was performed by coil embolization, including the extravasation site, and complete hemostasis was achieved. Carotid blowout syndrome (CBS) is involvement of the carotid artery by malignant processes of the head and neck with compromise of vessel integrity and rupture. Carotid hemorrhage (CBS type III) is fatal, especially when it occurs outside a hospital setting. Bleeding can occur through the skin or mucosa, and may cause airway compromise. It is associated with high mortality and morbidity. Endovascular parent artery occlusion (PAO) is the preferred management method and covered stents are an option for patients who are not candidates for PAO. In our case, additional left superficial and middle cerebral artery anastomoses was needed on the day after PAO for the prevention of hemodynamic cerebral infarction. Type 3 CBS can be fatal, so early recognition of CBS predictors by multidisciplinary teams is crucial for the prevention of fetal bleeding.