Carotid body tumors (CBTs) are rare neoplasms with rare malignant potential. These tumors are usually parasympathetic ganglia-derived lesions which located in the neck at the bifurcation of the external and internal carotid arteries. In contrary to sympathetic-derived tumors, they are often non-secretory. However, about 5% of these tumors may still secrete some of the catecholamine-related compounds. Most of these lesions are diagnosed in the third to fifth decades of life, with more cases revealed during autopsy examinations. Although it is considered a disease of middle age, elderly people are not immune. We report a case of an elderly patient in his eighth decade, who presented with a mass-like lesion in the right side of his neck during routine medical examination. Imaging study showed an enhancing mass in the carotid artery bifurcation with pressure effect and lymphadenopathy. The patient underwent surgery and tumor was removed uneventfully. The pathology report later confirmed ovalshaped cells with positive neuroendocrine markers consistent with carotid body paraganglioma. We believe these tumors are overlooked and yet may be missed without proper medical examination. We report this case for two reasons, being a very rare tumor with malignant potential in an elderly patient and to raise the awareness among medical practitioners.