Summary o 1. Eighty-five cases of penetrating injury to the carotid arteries are presented. 2. Hemorrhage, airway obstruction, and cerebrovascular damage are the major complications of this type of injury. Early exploration is mandatory if mortality and morbidity rates are to be reduced. 3. It is suggested that patients be placed in two categories: those without and those with neurologic deficits. The latter group present an extremely challenging problem in management. 4. Ligation may be the procedure of choice in a number of patients who have impairment of neurologic function. 5. Brain scanning may be a useful adjunct in planning surgical treatment.