Phlebectasia is a dilation of a vein. Jugular vein phlebectasia can occur in any part of the jugular venous system. It is an uncommon cause of cervical swelling in children. We report a rare case of bilateral internal jugular vein phlebectasia presenting as bilateral neck swelling in a child. We also review the literature on the clinical features of this entity and the differential diagnosis, methods of imaging, and treatment.