The aim is to report a case of retropharyngeal tortuous right internal carotid artery in a 74-year-old male patient. Anatomical variants of the carotid artery have been reported with a large variability of pattern and degree. Devastating complications can result from biopsy, surgical and anesthetic procedures in presence of a retropharyngeal internal carotid artery. A retropharyngeal mass is usually found in an asymptomatic patient during a routine head and neck examination. Symptomatic patients may present with complaints of dysphagia, abnormal voice, or foreign body sensation in the posterior pharynx.
