Carotid artery malignant aneurysm is generally not easy to spread when it is detected and treated at an early stage, but when it is detected at a late stage, distant metastatic spread may occur. Most patients with carotid artery aneurysm have no symptomatic manifestation, a few patients may have symptoms such as mass, local pain, etc. With the progress of the disease, compression symptoms may appear, such as hoarseness, dysphagia, dyspnea and other symptoms. Clinical patients with small and asymptomatic lumps should be followed up regularly, and generally they will not spread. Carotid aneurysm should be treated with surgery in time if uncomfortable symptoms appear, and the prognosis of most patients is good. However, when the patients are found late, it is easy to have distant metastasis and spread. Therefore, it is suggested that patients should achieve early detection, early diagnosis and early treatment to improve the prognosis.