Carotid sinus syndrome (CSS) is defined as syncope with reproduction of symptoms during 10s of carotid sinus massage. The etiology of this condition is unknown, patients are usually symptomatic and present with episodes of syncope. Due to the associated marked sinus bradycardia, sinus arrest or severe hypotension, carotid sinus syndrome may be life-threatening. In patients without previous symptoms, CSS must be promptly recognized and treated, otherwise may lead to catastrophic consequences. If symptoms of CSS appear for the first time during urgent symptomatic abdominal aortic aneurysm surgery consequences might be devastating. Herein, we describe a case of successful management of a patient with carotid sinus syndrome who has undergone urgent symptomatic abdominal aortic aneurysm open repair.