Abstract: Objective: To explore the clinical effects of coil occlusion in the treatment of massive hemorrhage caused by ruptured internal carotid artery pseudoaneurysm after radiotherapy for nasopharyngeal carcinoma, and analyze its safety and efficacy in combination with literature. Methods: A retrospective analysis was conducted on the clinical data of patients with massive hemorrhage caused by ruptured internal carotid artery pseudoaneurysm after radiotherapy for nasopharyngeal carcinoma in The Affiliated Hospital of Jiangnan University from 2022 to 2024.Among them, 6 patients were treated with direct coil occlusion of the internal carotid artery.The intraoperative internal carotid artery occlusion, postoperative rebleeding, death one year after the operation, recurrence of pseudoaneurysm and neurological function score of patients were observed. Results: The internal carotid artery was completely occluded in 6 patients, and the success rate of the operation was 100%.No rebleeding occurred after operation, no new neurological dysfunction was observed, the modified Rankin scale score was 0 to 1 point, and the 1-year survival rate after operation was 100%. Conclusions: Direct occlusion of the internal carotid artery in pseudoaneurysm segments with coil can effectively stop bleeding, and reduce the mortality rate of patients.However, it is necessary to conduct collateral circulation assessment through different methods during operation.