Carotidynia has an extensive differential diagnosis, including such conditions as pharyngitis, otitis, bruxism, temporomandibular joint syndrome, neuralgia, myalgia and temporal arteritis. Carotidynia may be divided into three distinct classifications: migrainous, nonmigrainous (or classic) and arteriosclerotic. Successful treatment depends on correct classification of the disorder. Ergotamine, propranolol and tricyclic antidepressants have been effective treatments in patients with migrainous carotidynia, and steroids and nonsteroidal anti-inflammatory drugs have proved effective for the classic type of carotidynia. Further investigation is required before it can be determined if treatment for the arteriosclerotic type should be medical or surgical.