Angioedema is a localized swelling of sudden onset, often associated with angiotensin-converting enzyme (ACE) inhibitor use, that most commonly occurs in the face and neck. We present the case of a patient on long-term ACE inhibitor therapy for hypertension, who developed postoperative angioedema after carotid endarterectomy (CEA). The patient was initially misdiagnosed with an expanding cervical hematoma and underwent a surgical wound reexploration. Angioedema is a rare cause of neck swelling and upper airway distress occurring after CEA in patients treated with ACE inhibitors and should be considered in the differential diagnosis.