&NA;The authors discuss 21 cases of large or surgically inaccessible internal carotid artery aneurysms treated with gradual occlusion of the cervical portion of the internal carotid artery. Eighty‐five per cent of the patients experienced relief or marked improvement of their symptoms after treatment. Two early cases developed postligation ischemic deficits that partially resolved. After the introduction of expansion of circulating blood volume and induced hypertension as adjuncts to graded carotid occlusion, no ischemic complications occurred.