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A female in her 40s presented with a left-sided neck swelling observed during straining, weightlifting and even on lying down, accompanied by mild pain and a feeling of light-headedness. She had no comorbidities and had no history of trauma or surgery in the neck. On examination, a left-sided, slightly bluish coloured supraclavicular swelling was observed on performing Valsalva manoeuvre ( online supplemental video 1). On palpation, the lesion was ill-defined, soft, non-tender and compressible, with a palpable thrill. Contrast-enhanced CT of the neck revealed a well-defined, thin-walled saccular outpouching (41 mm×39 mm) arising from the left internal jugular vein (IJV), suggestive of an IJV aneurysm (figure 1). She underwent excision of the aneurysm via transcervical approach following ligation of the narrow connecting stalk between the aneurysm and left IJV.