The clinical course and angiographic findings are described in a patient who developed cavernous sinus thrombophlebitis from a carbuncle on his upper lip. The case appears unique in that it was later complicated by the development of a carotico-cavernous fistula. The clinical manifestations of cavernous sinus thrombophlebitis and carotico-cavernous fistula are compared and contrasted. The angiographic findings in carotico-cavernous fistula are described and discussed. The difference in prognosis of cavernous sinus therombophlebitis and carotico-cavernous fistula for untreated patients and with different methods of treatment is outlined.