Traumatic pseudoaneurysm of the internal carotid artery(ICA) is a very rare but life-threatening clinical situation that needs the special attention of otolaryngologists, because it accompanies massive epistaxis. The authors have experienced four cases of traumatic pseudoaneurysm of the ICA. Three of them were successfully treated with detachable balloon embolization, however, one patient died of massive epistaxis before adequate management. This paper presents the clinical courses, diagnostic workup, and the results of the treatment. The highpoints of diagnosis and treatment were also discussed.