Abstract: Haemorrhagic complications of central venous catheterization (CVC) are well recognized. Accidental damage to carotid artery during CVC is frequently documented with accepted management guidelines. Acute respiratory distress due to complications of CVC is less frequent. However arterial damage causing acute life threatening respiratory distress with stridor is more infrequent. This causes a diagnostic challenge and difficulties in management due to the distortion of the anatomy of the larynx due to bleeding in to the anterior compartment of the neck. There are few reports of damage to thyroid arteries following CVC insertion. We report infrequent occurrence of the damage to superior thyroid artery and thyroid gland which caused acute stridor due to airway compromise. Our initial diagnosis was the more frequent damage to common carotid artery which was managed conventionally until the rapid onset of stridor and hypoxia. It necessitated immediate intubation using a narrow gauge endotrachial tube to overcome acute airway obstruction followed by surgical repair of the superior thyroid artery and evacuation of haematoma.