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We present a case of dysphagia caused by an aberrant internal carotid artery (ICA). By reporting this rare occurrence, we hope to highlight the anomaly as a differential in cases of persistent, progressive dysphagia. Even though the symptomatic mass effect of the ICA warranted the option of surgical intervention, due to a patient-centered approach with an emphasis on personal preference, the patient was instead referred for specialized ergotherapy. This case characterizes a rare yet significant cause of dysphagia, in addition, it illustrates the necessity of a multidisciplinary approach when dealing with complex cases of dysphagia.