Aneurysms of the subclavian artery are extremely rare in the clinical setting. They can occur secondary to atherosclerosis, cystic necrosis of the tunica media, trauma or infections. Open surgical repair is one of the main treatment choices especially of the extrathoracic subclavian artery aneurysm which can be repaired via a supraclavicular incision without sternotomy or thoracotomy. Herein, we present a case of a 63-year-old male with an expanding pulsatile mass of the right neck. A duplex ultrasound scan reported of a right common carotid artery aneurysm but the CT angiogram reported of mild intimal wall thickening and focal calcified plaques in proximal segment of right subclavian artery and site of branching of right common carotid artery. Open surgical repair via a right supraclavicular incision was successful. Pathological report of the aneurysmal sac was consistent with cystic medial degeneration.
