A 30-year-old Chinese woman presented with an enlarging pulsatile swelling in the left neck. A similar right neck mass was excised 2 years previously. Digital subtraction angiography showed a well-defined, hypervascular tumour situated at the left common carotid arterial bifurcation, typical of a carotid body tumour. Complete resection of the second carotid body tumour was achieved. The clinical and imaging features of this tumour are described.