Background: Pseudoaneurysms of the common carotid artery are rare but potentially life-threatening vascular lesions that can present with nonspecific symptoms. Their clinical presentation may mimic more common conditions such as cervical abscesses, leading to diagnostic delays and inappropriate management.

Case Presentation: We report a case of a 45-year-old male presenting with a painful, progressively enlarging neck mass accompanied by dysphagia and low-grade fever. Initial clinical and radiologic evaluations suggested a cervical abscess. However, further imaging with contrast-enhanced CT and Doppler ultrasound revealed a pseudoaneurysm of the right common carotid artery. Surgical intervention was performed, and the diagnosis was confirmed intraoperatively.

Conclusion: This case underscores the importance of maintaining a high index of suspicion for vascular anomalies in atypical neck masses. Prompt use of appropriate imaging modalities is essential for accurate diagnosis and timely intervention to avoid catastrophic complications.