This case report presents a 64-year-old man who presented with a transient ischemic attack and significant carotid stenosis. On the fifth day after endarterectomy, the patient developed a headache with a cluster-like phenotype. Complementary investigations using brain magnetic resonance imaging and cervical arterial angiography did not reveal any signs of complications. Treatment was carried out with oxygen and verapamil, according to the phenotype, and the symptoms disappeared in just over a month. This case highlights the importance of considering headache as a potential complication of carotid endarterectomy. It is worth remembering that although headache is relatively common in the postoperative period, when present, it is necessary to perform additional tests to rule out ischemic or hemorrhagic complications, stenosis or cervical arterial dissection.