More than a century ago, Coulson1reported the case of an 82-year-old woman "who for some years before her death had a pulsatile tumor, of the size of an orange, just above the right clavicle, in the situation of the carotid. The swelling had not of late increased in size and caused no inconvenience; the woman died from natural decay." This mass, which was considered to be an aneurysm, was shown at postmortem examination to be a tortuous right common carotid artery. Since then some 117 cases of kinked right common carotid or innominate artery or both have appeared in the literature with thorough reviews by Parkinson2and co-workers and Deterling.3Buckling of the internal carotid artery, however, appears to have been practically forgotten; Kelly4had stressed its benign nature in 1924. In the present report we wish to call attention to several aspects of buckling