Arteriosclerotic occlusive lesions of the brachiocephalic system were well described by Broadbent in 18752 and Penzoldt in 1881.13 The significance of these lesions in the production of cerebral insufficiency was later emphasized by Chiari in 19053 and Hunt in 1914.7 The most common pathological process is an occlusive atheromatous plaque at the level of the common carotid bifurcation. The surgical management of this lesion is well established. Endarterectomy has been regarded as the procedure of choice.1,4,5,9 Obstruction of the extracranial portions of the carotid and vertebral systems can also occur due to external pressure by bony projection or by kinking of the vessels.10,11,14 The purpose of this presentation is to report our experience with kinked internal carotid artery. Clinical Material In a series of 308 patients subjected to carotid surgery, 248 underwent carotid bifurcation endarterectomy and 15 were operated upon for the relief of