Context:The pituitary gland involvement secondary to IgG4-RD is a rare entity, in addition, no reports have been identified in the literature of occlusion of the cavernous portion of the internal carotid artery, due to extrinsic compression. Case description:We present a female patient of 54 years with panhypopituitarism, imaging findings highly suggestive of IgG4 hypophysitis, with elevated serum and CSF IgG4 levels and histopathological findings demonstrating dense fibroconnective tissue with hypereosinophilic sclerosis, these findings consistent with associated IgG4-related hypophysitis, as well as atypical sinus involvement cavernous and occlusion of the left carotid by extension of the inflammatory process, with good collateral circulation. Conclusion:The patient was treated with steroids and Rituximab, with a decrease in serum IgG4 values and clinical improvement.