&NA;Penetrating injuries of the internal carotid artery at the base of the skull often require permanent or transient occlusion of the injured vessel during repair. Extracranial‐intracranial bypass (EC‐IC) was employed in five patients to insure adequate cerebral perfusion during cervical exploration. Preoperative neurologic deficits were noted in three patients; two demonstrated complete reversal following EC‐IC. This experience suggests that EC‐IC can maintain adequate cerebral perfusion during repair of internal carotid injuries and allow selective revascularization of patients with neurologic deficit and carotid occlusion.