Carotid body tumors and paragangliomas of the neck are rare mostly benign tumors. As otolaryngologists, we are asked to be leaders in the management algorithms for these complex patients. The goals of this lecture will be to define tumor characteristics and genetics associated with paragangliomas to better implement strategies for testing, treatment, and surveillance. We will also review imaging characteristics associated with each location in order to recognize the likely origin and help define strategies at each site. Finally a review of the indications for observation, radiation and surgery will be reviewed with a detailed explanation of key surgical landmarks and technical considerations.