This course will address the (1) prevention, (2) acute intraoperative management, (3) perioperative management, and (4) team training for carotid artery injury during endoscopic sinus or skull base surgery. Prevention of injury with preoperative assessment and proper surgical technique will be stressed. Anatomical dissections will be used to highlight relevant surgical anatomy. Drawing on our extensive surgical experience in dealing with vascular injuries during endoscopic skull base surgery, we will use case studies with surgical videos to demonstrate surgical techniques. Expert consensus with review of literature will be used to emphasize best practices. A treatment algorithm for intraoperative and perioperative management will be reviewed. Team training for intraoperative management will be demonstrated. This course will improve your ability to avoid and manage carotid injury during endoscopic sinus surgery.