Small carotid body tumors that do not encircle the internal carotid artery are excised with relative ease and minimal risk by the conventional subadventicial approach. Large carotid body tumors frequently encircle the internal and external carotid arteries, and extensive bleeding often complicates the resection, increasing the risk of carotid artery rupture and damage to major cranial nerves. Recent improvements in surgical techniques and selective embolization have lessened the risks of surgical excision, decreased the blood loss, and diminished the time required for resection. Experiences in the resection of carotid tumors with and without embolization are compared. Early resection of carotid body tumors, before involvement of the internal carotid artery and carotid bulb, is advocated.