Carotid stenosis is a common cerebrovascular disease, especially in the middle-aged and elderly population, and has become one of the “number one killers” of people’s health in today’s society. According to relevant statistics, about 60% of ischemic strokes are caused by carotid stenosis, and severe cerebral infarction can lead to disability or even death. Most carotid stenosis is caused by atherosclerosis, a thickening of the blood and lipid deposits on the inner wall of the carotid artery, which over time form plaques and block the lumen, resulting in carotid stenosis. Carotid artery stenosis will affect the blood flow, resulting in insufficient blood supply to the brain, and even if the plaque dislodged with the blood flow into the brain, it will cause a deformed brain infarction, which is very dangerous. Therefore, if carotid artery stenosis is found, it should be taken seriously and treated early. Carotid artery stenosis is especially graded, and the treatment is different for different degrees of stenosis. In general, for mild stenosis with a stenosis rate of less than 50%, conservative medical treatment is feasible; while for moderate to severe stenosis with a stenosis rate of 50% or more, surgical treatment is required depending on the situation. Currently, carotid endarterectomy is an effective surgical procedure. Do I need surgery for bilateral carotid stenosis? If the stenosis rate is greater than 50% and the indication for surgery is met, bilateral carotid stenosis also requires surgery, and both sides need to be operated on. Depending on the patient’s condition, the surgeon will perform a carotid endarterectomy on one side first, and then perform the procedure on the opposite side about two weeks apart. Carotid endarterectomy can completely remove the carotid plaque that caused the stenosis, completely restore the lumen of the carotid artery and improve the blood supply.