Arteriovenous fistulae are abnormal direct communications between artery and venous system. It rarely occurs in superficial temporal vessel and is usually caused by trauma. Clinical manifestation includes pulsatile mass, headache, hemorrhage and tinnitus. Angiography is standard diagnostic modality and surgical removal of the pulsating mass with ligature of the feeding vessel is definitive treatment. The authors describe the case of a 35-year-old female patient who developed a pulsatile tortuous mass, extending from the left preauricular area to the left scalp after sustaining thorn injury (extremely rare penetrating injury). The treatment done was a complete surgical removal of the pulsatile mass and ligature of the feeding superficial temporal artery.