Abstract Objective: Evaluate surgical outcomes of Carotid body tumors (CBT), especially postoperative complications (PC) and the influence of cranial nerve injuries (CNI) on patients’ quality of life (QoL). Design: A prospective follow-up study (2004-2020) utilizing a database from Charité University Hospital and follow-up questionnaires EORTC QLQ-C30 and QLQ-H&N43. Setting: A single-institution study. Participants: Patients with histopathologically confirmed CBT and an ICD code 44.6. Main Outcome Measures: Tumor characteristics, complications, and postoperative QoL (EORTC QLQ-C30, QLQ-H&N43) Results: From 40 identified CBT patients, 55% were females with an average age of 51.1. 47.5% tumors were right-sided; 70% presented with painless neck swelling. 12.5% had a Succinate dehydrogenase mutation. Average tumor volume was 133 cm³. CNIs affected 45%. Preoperative embolization (PE) was done in 47.5%, not reducing PC (p=0.98). No association was found between tumor size and PC: gender (p=0.7), age (p=0.847), co-morbidities (p=0.13). Average stay was 8.07 days. Patients without complications had better QoL (M=92.59 vs. M=69.44, p=.019); those without CNIs also had better QoL (p=.068). Males had superior QoL scores (p=.05). PC affected functioning, especially social functioning (p = .05) and CNX injury (p= .041). Conclusion: CBT surgery significantly affects nerve function and QoL. The results present the need for effective postoperative care, monitoring and management of complications to boost patient outcomes. Gender differences in QoL after CBT surgery merit further investigation into possible physiological and environmental factors.