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A female in her mid-60s complained of a painless, slowly growing swelling on the right side of the neck. A firm pulsating expansile mass was noted on clinical examination without neurological restriction. Imaging studies (CT angiography, MRI and digital subtraction angiography) demonstrated a well-defined hypervascular lesion in the carotid bifurcation and a sign of easy splaying of the internal and external carotid arteries, which confirmed the diagnosis of a carotid body tumour (CBT). Transcervical surgical removal of the tumour was performed. Histopathologic examination findings were consistent with a paraganglioma with a characteristic Zellballen pattern. The patient recovered uneventfully and is doing well so far. The case emphasises the need to consider CBTs in the differential diagnosis of lateral neck masses and highlights the role of imaging in diagnosis and preoperative planning.