Syncope caused by carotid sinus syndrome due to head and neck cancer is rare. We report a case of recurrent syncope as a result of extreme bradycardia requiring pacemaker implantation. The patient began chemotherapy and radiation therapy to treat the underlying cause. When diagnosed early, a positive outcome is expected in these situations. LEARNING POINTS The differential diagnosis of transient loss of consciousness is frequently evident at clinical examination but may prove to be a challenge. The invasion and direct compression of the carotid sinus is a rare cause of carotid sinus syndrome and presents clinically as syncope.