BACKGROUND: Paraganglioma (PGL) is a rare neuroendocrine tumor. In the head and neck region, surgical resection of PGL is extremely difficult due to its proximity to many vital blood vessels, nerves, and organs. There is still some controversy about whether preoperative embolization is salutary. METHODS: We present a case of a giant left common carotid artery PGL with nodular goiter, which needs surgical resection combined with interventional and endovascular treatments. RESULTS: The patient recovered well after the operation without vascular and nerve injury complications. His chest tightness and dysphagia also resolved after the surgery. CONCLUSIONS: This case highlights the importance and effectiveness of interventional and endovascular treatments in complex head and neck PGL (HNPGL), particularly in cases involving important blood vessels and organs.