Three cases of internal carotid artery(ICA) injury during endoscopic endonasal surgery were analyzed,including 1 case of recurrent malignancy of sphenoid sinus,1 case of intraorbital meningioma and 1 case of optic neuropathy.Salvage sphenoid sinus packing with gauze strip was managed in all the three cases.One patient operated a permanent closure of the carotid system intraoperatively and died after surgery.Among 2 survival cases,one patient accepted the endovascular embolization subsequently;the other patient was cured by intravaseular stent graft implantation without craniocerebral or ocular complicatitms.