We report a case of transient hoarseness of voice secondary to inadvertent recurrent laryngeal nerve blockade while performing carotid endarterectomy under superficial and intermediate cervical plexus block anesthesia. Though we could not pinpoint the exact cause of recurrent laryngeal nerve block in this case, but have postulated few possible causes for this nerve block. This case highlights that inadvertent recurrent laryngeal nerve block can happen even when ultrasound guided superficial and intermediate cervical plexus block are used in clinical practice.