Pharyngomaxillary space abscess complicated by carotid artery erosion is now an uncommon disease. Two cases recently came under our care within a short period of time. The history of tonsillitis or other oropharyngeal infection followed by an enlarging tender neck mass with neurological involvement of cranial nerves IX through XII and the cervical sympathetic chain should alert one to the correct diagnosis. Treatment must be aggressive. A Mosher-type incision is most satisfactory, and the surgeon must be prepared to ligate the great vessels of the neck if any severe hemorrhage is encountered.