Anomalies of the carotid artery are rare in clinical experience. To our knowledge a tortuous common carotid artery with an abnormal course encountered during neck dissection has never been reported in the available world literature. During dissection of the lower neck in a 60-year-old Korean man, a tortuous right common carotid artery was found to cross over the lower cervical trachea anteriorly and then was positioned in its usual site in the carotid sheath in the mid-neck.