Internal jugular vein ectasia or phlebectasia is a condition in which there is an isolated fusiform dilatation of the internal jugular vein. The patient usually presents with swelling in the neck, which aggravates in size while coughing or straining. This is a rare condition and is often mis-diagnosed. It can be diagnosed by proper history, clinical examination and imaging. We report a 5-year-old boy who had bilateral internal jugular vein ectasia aggravating in size while straining and coughing. Ultrasonography and computed tomography scan showed dilatation of internal jugular veins on both sides. Since the patient was asymptomatic and had no complications, he was advised regular follow-up. This rare benign condition should be kept in mind as a differential diagnosis of an expansile neck mass.