This is a retrospective review of 27 patients radiologically diagnosed as having metastases involving the common or internal carotid arteries. All patients underwent a salvage neck dissection with surgical carotid peeling. Thirteen of the 27 achieved loco-regional control, five developed second primaries and 11 distant metastases. The survival time was noted to be poor regardless of regional control with the medial survival being 1.5 years and disease free survival 0.7 of a year. A two year disease free survival rate of 22% was observed. No patients in this review sustained the complication of arterial rupture however a small number of cases had previously had preoperative radiotherapy.