Any pulsatile neck mass after extracorporeal membrane oxygenation (ECM
O) must be viewed as a pseudoaneurysm of the carotid artery until prov
en otherwise. Prompt diagnosis is necessary utilizing ultrasound. Angi
ography may not be necessary. Carotid artery pseudoaneurysm requires u
rgent surgical intervention to prevent catastrophic hemorrhage. The ut
ilization of cardiopulmonary bypass may facilitate safe repair.