Injury to the oropharynx can be potentially life threatening. Innocent-looking injuries of the oropharynx may result in intravascular thrombosis of the internal carotid artery. The symptoms often appear some time after the initial injury. We present a case in which an apparently minor injury of the oropharynx developed into a life-threatening thrombus stretching from the internal carotid to the brain. Our patient underwent endarterectomy and thrombectomy. The case is presented with a review of the literature.