The most common form of carotidynia is related to overdistention, relaxation, and increased pulsation in the carotid artery. This syndrome of vascular neck pain is closely associated with various forms of extracranial vascular headache. Analysis of 100 consecutive cases of carotidynia has revealed that it is more common in women than in men in a ratio of about 4 to 1; it occurs at almost any age but is most prevalent during the fourth and fifth decades; and there is often a history of vascular headache. The only significant abnormality on physical examination is the presence of a tender, throbbing, often dilated carotid artery. The condition is frequently misdiagnosed and therefore not properly treated. The preferred treatment is similar to that used for migraine and other painful vasodilating conditions of the head.