Extracranial carotid artery injuries may produce severe haemorrhage, cerebral damage or arteriovenous fistula. Examples of traumatic extracranial carotid-jugular fistula are not frequently reported, especially in forensic medicine. We report a controversial case of an extracranial inteal carotid-jugular fistula resulting from a stab wound to the neck. The degree of the injury was classified under "The Standard of Human Body Injury Assessment (2014)" (SIA) in China by forensic examiners. We believe this case report will provide information for the forensic assessment of similar cases.