The carotid artery is a vital vascular pathway that supplies blood to the brain and face. Therefore, carotid arteries should not have lesions that could directly threaten life and health. However, in recent years, there has been a high incidence of cerebrovascular diseases such as carotid stenosis, and patients have been feeling anxious. Carotid artery stenosis should be taken seriously and treatment measures should be actively taken to avoid triggering more health hazards. Carotid artery stenosis can be unilateral or bilateral, and the situation varies from patient to patient, requiring different response options. Can I have bypass surgery for bilateral carotid stenosis? In principle, carotid artery stenosis less than 50% does not require surgical treatment, and can be better recovered with the help of medication and life conditioning; while if the stenosis reaches more than 50%, surgical treatment is required depending on the specific situation, and carotid endarterectomy and intracranial and extracranial vascular bypass surgery are currently carried out clinically. It is understood that carotid endarterectomy is the preferred treatment option for patients with moderate carotid stenosis, through which patients can be helped to peel off the sclerotic plaque causing carotid stenosis, thus restoring smooth blood flow in the official cavity of the carotid artery and achieving normal blood supply; while intracranial and extracranial vascular bypass surgery is the surgical approach required for patients with complete occlusion of the carotid artery. Bilateral carotid artery stenosis should be treated actively and effectively, regardless of the method of treatment, it should be noted that, for safety reasons, surgery must be performed on one side first and then on the other side after an interval of about two weeks, depending on the patient’s specific situation.