Angiotensin-converting enzyme inhibitors are the most common medications used for control of hypertension. Their positive effect on survival makes them an important drug in essential hypertension and heart failure; however, they pose a number of adverse effects that may present to otolaryngologists. Cough is the most common side effect limiting their use. Angioedema is a dangerous side effect that may be fatal when it involves the airway. It is important to recognize and manage these adverse effects. This article reviews the epidemiology, pathophysiology, and management of these adverse effects related to angiotensin-converting enzyme inhibitors.