Two cases of tumours of the carotid bifurcation are reported here with the objective of outlining a rational approach to their management. A review of the literature confirms that the bad results of surgical treatment are largely due to jeopardization of the carotid circulation at the time of operation. Carotid angiography is therefore essential not only to confirm the anatomical diagnosis but also to provide an indication of the adequacy of the carotid circulation. It is a sine qua non for rational operative decisions which form the basis of safe excisional surgery of these tumours.