The authors describe a case of a complex glomus jugulare tumor with extensive involvement of the venous system. The entire left internal jugular vein up to its innominate insertion was involved with tumor, with proximal extension to the sigmoid sinus, transverse sinus, and the torcular herophili. Gross-total resection of the tumor required a two-stage median sternotomy. This is the first case report of a glomus jugulare tumor in which there was such extensive involvement of the venous system, requiring a multidisciplinary team approach for complete resection.