An extracranial carotid artery aneurysm in a child misdiagnosed as a parapharyngeal abscess is presented. Diagnosis modalities of cervical masses and features of aneurysms are discussed. It is stressed that. regardless of age, in the presence of a pulsating and tender cervical or parapharyngeal mass, an aneurysm is probable. Prior to any intervention, at least non-invasive screening tests must be performed. Failure may lead to disastrous results.