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Eagle’s syndrome is an abnormal elongation of the styloid process. The abnormality can lead to orofacial pain. Treatment consists of surgical shortening of the styloid process. This report discusses an uncommon occurrence of symptomatic carotid disease in the setting of Eagle’s syndrome. A 73-year-old male presented to clinic with >70% stenosis of the right internal carotid artery. Reviewing the computed tomography angiography revealed an enlarged styloid process superficial to the right internal carotid artery. Upon questioning, the patient related the orofacial pain of Eagle’s syndrome with chewing. In combination with plastic surgery, we performed resection of the styloid process and carotid endarterectomy.