This is a retrospective report on 22 patients with carotid body tumours (intercarotid paragangliomas or carotid chemodectomas) treated by excision using either the dissection technique or en bloc resection. The type of operation to be carried out can be predicted pre-operatively by measuring the carotid bifurcation angle or degree of splaying of the carotid arteries. An angle of less than 90 degrees implies that the tumour can be dissected off the internal carotid artery. An angle of more than 90 degrees implies that it will probably require en bloc resection, including the carotid bifurcation, followed by carotid reconstruction.