Traumatic injury to the level III internal carotid artery (ICA) is infrequently encountered; however, rapid and effective treatment is mandatory for the prevention of a neurological catastrophe. Many case reports have demonstrated decreased morbidity and mortality of endovascular repair of traumatic injury to large vessels using covered stents or endovascular coiling of posttraumatic pseudoaneurysms. We present the case of a transected level III ICA requiring emergent, complex sacrifice.