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 in order to implement strategies for testing, treatment and surveillance. We will review associated imaging characteristics to recognize the likely origin and help define strategies for care for each site. Finally, we will review the indications for observation, radiation and surgery. Surgery will be reviewed with a detailed explanation and demonstration of key surgical landmarks and technical considerations, as well as post-operative care.