A 46-year-old woman noted a right-sided neck lump one year ago. A CT scan demonstrated a right-sided 2 cm mass located between the external and internal carotid arteries that enhanced with contrast and caused splaying of the carotid bifurcation, suggesting a carotid body tumor (Figure A). She had no neurological symptoms. She underwent surgical excision of the mass, without trauma to the carotid vessels and care was taken to identify the Hypoglossal and vagus nerves. Intraoperatively, the mass was found to be supplied by several small vessels from the external carotid artery but without any attachment to the arterial walls (Figure B), consistent with a Shamblin Class 1 carotid body tumor. Hematoxylin and eosin stains showed nests of cells with eosinophilic cytoplasm separated by a hyalinized stroma, with no evidence of anaplasia or invasion, consistent with a Paraganglioma. Postoperatively she recovered with no complications. Surgical excision remains the only curative treatment for this type of tumor, and recurrence is rare.