Carotid sinus syndrome is a rare condition that is characterized by paroxysmal episodes of syncope, bradycardia and hypotension, the exact etiology of which remains unclear, it is also a rare finding in head and neck cancer patients In this article we present a case of a 60 year old male who is a known case of Carcinoma Left lateral border tongue with nodal recurrence and developed the above features of carotid sinus syndrome while undergoing treatment with external beam radiation therapy. It also states the interventions and modifications done during treatment to overcome the problem of carotid sinus syndrome such that radiation could be completed