Accessory nerve palsy due to surgery in the anterior triangle of the neck is uncommon. Two such cases 1, after a carotid endarterectomy and the other after rhytidectomy, are described here. Both cases were treated with analgesics and physical therapy. Followup evaluation after 1 year revealed complete clinical and electrophysiologic recovery in only the first case. Recognizing accessory nerve palsy after surgical procedures in the necks is emphasized as important for proper management. An attempt is made to explain the reason for lack of improvement in the second case.