Extracranial carotid artery aneurysms (ECAA) are less commonly seen disease. It is still difficult to determine the optimal treatment strategy because of limitations in reporting of results and confounding by indications based on the available literature. We depict a hybrid operation combining surgery with balloon occlusion to achieve distal outlet control, aneurysm resection, and reconstruction of parent internal carotid artery for the treatment of extracranial carotid artery aneurysms with good outcomes according to a 2-year follow up. We conclude that a hybrid operation combining surgery with endovascular assistance yields a safe and effective choice for the treatment of extracranial carotid artery aneurysms.