Extracranial carotid artery aneurysms are less commonly observed. Hence, determining the optimal treatment strategy is difficult because of limitations in the reporting of results and confounding by indications based on the available literature. Here, we present a hybrid operation combining surgery and balloon occlusion to achieve distal outlet control, aneurysm resection, and reconstruction of the parent internal carotid artery for the treatment of extracranial carotid artery aneurysms, with good outcomes based on 2-year follow-up. We conclude that a hybrid operation combining surgery and endovascular assistance is a safe and effective choice for the treatment of extracranial carotid artery aneurysms.