Bilateral common carotid ligation was performed successfully in a patient with bilateral giant intracavernous carotid artery aneurysms. The patient presented with complete left ophthalmoplegia and impending right ophthalmoplegia, which was treated with right carotid ligation followed one week later by subtotal left carotid occlusion. Subsequent to this treatment, the patient had a dramatic recovery and remains well one year following operation.