Carotid artery stenosis is a relatively common cerebrovascular disease among the middle-aged and elderly population and is an important factor in cerebral infarction. According to statistics, more than 60% of ischemic strokes are caused by carotid stenosis. It has become a major killer of human health. Therefore, it is important to treat carotid stenosis promptly if you suffer from it. According to its stenosis rate, carotid stenosis is divided into four grades: mild stenosis if the stenosis rate is less than 50%, moderate stenosis if the stenosis rate is 50%-70%, severe stenosis if the stenosis rate is more than 70%, and carotid occlusion if the stenosis rate reaches 100%. Different degrees and grades of carotid artery stenosis are treated differently. In general, it is recommended that mild carotid stenosis should be treated conservatively by internal medicine, taking antiplatelet drugs and plaque stabilizing drugs as prescribed by regular hospitals, changing bad habits, maintaining good living and eating habits, and regular review; for moderate carotid stenosis, treatment should be decided according to the patient’s specific symptoms and the nature of plaque, etc. Patients with asymptomatic and stable plaque can be treated conservatively, while patients with symptoms or unstable plaque are recommended to undergo surgery promptly. For patients with severe carotid artery stenosis, regardless of whether they have symptoms or not, whether the plaque is stable or not, they need to be operated as soon as possible, and the surgical methods are carotid endarterectomy or carotid stenting; for patients with carotid occlusion, depending on the patient’s specific condition, intracranial and extracranial vascular bypass surgery can be taken to treat them if necessary. Some patients ask which is more expensive: carotid artery stripping or stenting? It depends on what kind of stent is used. Some imported stents are expensive and may cost much more than stripping, while domestic stents may not cost less, although there may be room for reduction in the future. However, there are still some disadvantages of stenting, such as the relatively high rate of restenosis after surgery, the risk of intra-stent thrombosis, foreign body reaction, stent fracture and collapse, and the need for long-term medication after surgery. Therefore, in contrast, carotid endarterectomy has greater advantages in terms of better flow reconstruction, lower restenosis rate, and no need for long-term medication. Carotid endarterectomy for carotid artery stenosis has achieved good clinical results. Carotid endarterectomy is a standard operation recognized by the medical community at home and abroad for the treatment of carotid stenosis and prevention of cerebral infarction. The operation is performed under a microscope with high safety, and after peeling off and removing the atherosclerotic plaque, the source of emboli is eliminated, the carotid artery diameter returns to normal size, and blood flow is restored, which greatly improves cerebral blood supply and prevents cerebral infarction. Therefore, carotid endarterectomy should be the priority treatment modality; for patients who cannot tolerate stripping surgery, stenting can be an alternative option.