Introduction: Carotid body tumor (CBT) is a type of paraganglioma, with an incidence of 3-4 per 100,000 inhabitants per year. These tumors are often diagnosed incidentally, though they may present with dysphagia, dysphonia, adrenergic symptoms, and vessels compromise. Diagnosis is confirmed through computed tomography, and the only curative option is surgery, which carries various risks and complications and requires advanced surgical technique. Case presentation: Two patients with carotid body tumor were referred to the vascular surgery service. Both underwent successful tumor resection. One patient had a favorable outcome, while the other developed dysphagia and dysphonia due to the sectioning of a loop of the hypoglossal nerve to free the tumor. Discussion and conclusion: CBTs are typically benign and have the lowest malignancy rate among all paragangliomas, reported to be less than 5%. The standard surgical technique involves periadventitial resection and presents significant therapeutic challenges depending on the tumor's location and involvement of adjacent structures. The most common complications include damage to the vagus and hypoglossal nerves, with average blood loss ranging from 78 to 404 ml. Given the complexity of these complications, highly specialized surgeons are required, and modifications to conventional surgical techniques, including preoperative tumor embolization, have been proposed.