Glomus jugulare tumors are a rare subset of benign, slow-growing neoplasms originating from neuroectodermal tissues, particularly around the jugular bulb, and can affect the lower cranial nerves. Despite an annual incidence of approximately one case per 1.3 million people, these tumors predominantly impact adults and the elderly, showing a higher prevalence in women and a left-sided preponderance. Symptoms often include tinnitus, hearing loss, and cranial nerve deficits. We present a rare case of a 62-year-old woman with a glomus jugulare paraganglioma involving the vagus and hypoglossal cranial nerves, presenting with a four-year history of hearing loss and pulsatile tinnitus, alongside recent dysphagia and vocal changes. Diagnostic imaging revealed a lobulated, enhancing lesion with a characteristic 'salt and pepper' appearance on MRI, consistent with a glomus jugulare paraganglioma. Despite being advised to undergo surgical resection, the patient opted for radiotherapy, leading to the successful management of the tumor. This case underscores the importance of early diagnosis through effective imaging and highlights the ongoing debate regarding optimal treatment strategies for glomus jugulare tumors. While surgery remains a cornerstone for treatment, particularly in younger patients, radiotherapy, including stereotactic radiosurgery, presents a viable alternative with favorable outcomes and reduced morbidity. This case supports individualized treatment approaches based on patient preferences, tumor characteristics, and potential risks.