Head and neck paragangliomas can be a clinical challenge to providers identifying these rare neural crest-derived tumors. They present with unique clinical exam findings, radiologic characteristics, and histopathologic features. Therefore, providers should approach management, including surgery, radiation, and observation, with up-to-date knowledge of the literature, particularly as it pertains to hereditary paragangliomas. Recent studies have changed the way we should manage patients. There is a greater emphasis on watchful waiting and new data on when, where, and how patients should be serially imaged. This information is critical to providing an evidence-based survivorship program, including monitoring for recurrence, progression, or second primary paragangliomas. This panel will begin with a brief review of head and neck paragangliomas as well as an updated overview of diagnosis, hereditary disease, and a cost-effective model for genetic testing. Next, recent literature will be applied to provide evidence-based guidelines on clinical management, including personalized longitudinal surveillance and survivorship. Lastly, Dr. Netterville will provide practical lessons from his several decades of experience. Each of these topics will be followed by case presentations to apply these concepts to the management of actual patients. This session will be conducted using audience polling software to facilitate engagement and discussion among the panelists while highlighting fundamental principles and guidelines.