Carotid stenosis is a narrowing of the carotid lumen due to atheromatous plaque in the carotid artery, mostly in the bifurcation of the common carotid artery and the beginning of the internal carotid artery. Some stenotic lesions may even progress to complete occlusive lesions. What are the risks of carotid artery stenosis? Ischemic stroke is a common risk of disability, and carotid stenosis is very closely related to ischemic stroke. Common causes include (1) reduced cerebral perfusion due to severe stenosis, and (2) cerebral infarction due to dislodgement of atheromatous plaque in the carotid artery or dislodgement of microthrombi formed by plaque rupture. The latter cause is particularly common. The main symptoms caused by carotid stenosis are transient dizziness, blackness in front of the eyes, transient weakness of one limb, and even serious consequences of permanent hemiparesis. Therefore, carotid stenosis should be treated actively. How should carotid artery stenosis be treated? First of all, carotid artery stenosis should be given high priority and risk factors should be actively controlled, and antiplatelet therapy is beneficial. For patients with carotid artery stenosis of 50% or more with clinical symptoms, or patients with stenosis of 70% or more, surgical treatment should be actively undertaken. Aggressive surgical treatment is effective in reducing the incidence of stroke and hemiparesis events. What are the surgical treatments for carotid stenosis? The surgical treatment of carotid stenosis is basically divided into 2 types: (1) carotid endarterectomy, which is a classical surgical procedure, widely performed at home and abroad, with confirmed surgical results. (2) Carotid artery stenting, which is a minimally invasive treatment with little trauma and quick recovery, has been widely carried out in recent years to achieve a cure through stenting. Vascular surgery has accumulated rich experience in both carotid endarterectomy and carotid artery stent implantation, and has solved the disease for a large number of patients.