Combined rupture of abdominal aortic aneurysm and acute thrombosis of internal carotid artery is extremely rare but fatal combination resulting in high mortality rate. Presented case, shows suc-cessfully performed simultaneous surgery of rup-tured abdominal aortic aneurysm and acute cere-brovascular insult caused by thrombosis of carotid artery in 81 year-old male. Post operative course was uneventfull. At 24 months follow up pa-tient was in good condition, with full neurological re-covery. Simultaneous surgical treatment of acute oc-clusive carotid disease and ruptured abdominal aortic aneurysm (RAAA) seems to be the only life saving procedure for this rare, but very complicated condi-tion. To our knowledge, this is the first reported suc-cessful simultaneous surgical treatment of RAAA and acute thrombosis of internal carotid artery. Key words: abdominal aortic aneurysm rupture, acute cerebrovascular insult, surgical treatmen
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