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Vascular masses in middle ear space are uncommon, and include high dehiscent jugular bulb or a glomus tumor occurring most frequently. The bone over the carotid artery may be dehiscent, resulting in the appearance of a vascular mass in the anteroinferior quadrant as it passes in its usual course through the middle ear. Less frequently, internal carotid artery courses aberrantly within middle ear space. If aberrant carotid artery was misdiagnosed, surgical intervention can lead to massive bleeding, possible hemiparesis, or both. We found vascular mass in middle ear during tympanomastoidectomy in a patient with tinnitus. Postoperatively we checked up dynamic temporal bone CT and diagnosed aberrant carotid artery. (J Clinical Otolaryngol 2000;11:124–128)