We report a left common carotid artery pseudoaneurysm in a 47-year-old bricklayer with no prior surgical procedures or acute neck injury. At operation, the pseudoaneurysm was found to be related to ongoing injury to the carotid artery from the tip of the hyoid bone. The most likely explanation for this was that the patient's job required that he carry cement panniers weighing about 15 kg on his left shoulder and that these panniers repeatedly compressed the left side of his neck, thus forcing the carotid against the hyoid.