Carotid atherosclerosis (CAS) is one of the risk factors for cerebral infarction, and it has been reported that about 20%-30% of cerebral infarction is associated with its development. Therefore, the study of carotid atherosclerosis (CAS) has become a hot topic in clinical prevention and treatment of cerebral infarction. However, in the recent literature, there is little discussion on the Chinese medical name of CAS plaque, and the diagnosis of “CAS plaque” is generally used. However, CAS plaques cannot express the Chinese medical understanding of the pathological mechanism and characteristics of the disease. CAS plaque is a lesion discovered with the help of contemporary technology, therefore, it is not recorded in the traditional literature. The presence or absence, location, size, number, and nature of CAS plaques can be detected by imaging means, which should be an extension of the traditional diagnosis method of TCM. The basic consensus has been formed by contemporary medical practitioners. The term “accumulation” is a general term used by Chinese medicine to describe a variety of pathological changes caused by the accumulation of tangible evil in the human body. The Jin Kui Yao Yao says: “The accumulation is also a dirty disease, which never moves.” The Jing Yue Quan Shu summarizes the characteristics and process of accumulation as follows: “Accumulation is the term for the accumulation of bases, which are formed gradually.” The Medical Lin Jumo states, “Anyone who has lumps on, in, or under the body is mostly phlegm.” From ancient times to the present, it is believed that localized lumps with fixed sites are phlegm as stasis. In Chinese medicine, the carotid artery is called the Renying pulse, and the CAS plaque is knotted in the Renying pulse, which is consistent with the above pathomechanical characteristics of “accumulation”. Therefore, CAS plaques can be named as accumulation in the Ren-Ying vein. The occurrence and development of CAS are generally related to age, diet, smoking, alcohol consumption, chronic diseases (hypertension, hyperlipidemia, diabetes, etc.), snoring, obesity, and long-term mental stress. The author’s clinical investigation and study of 185 CAS patients found that fire-heat evidence accounted for 124 cases, while snoring, smoking, salty, stressful, spicy, and hypertension were common influencing factors of fire-heat pathology, and CAS fire-heat evidence was similar to stroke disease in terms of risk factors and degree of atherosclerosis. In addition, modern studies have confirmed a strong relationship between CAS and ageing. Among the 185 CAS patients collected, the majority of age was concentrated between 50 and 70 years old, with 170 cases over 50 years old, accounting for the majority, and most between 60 and 70 years old. Therefore, the etiology of CAS mainly involves both evil knots and positive deficiency. Old age and physical weakness, or long-term illness and injury to the righteousness, resulting in deficiency of qi and yin and deficiency of liver and kidney, are the basis for the formation of Renying pulse accumulation. According to the Nei Jing, “when a woman is five or seven, her Yang Ming pulse declines” and when a husband is six or eight, his Yang Qi is exhausted on the top, his face is scorched and his hair and temples are white”, which contains the mechanism of the formation of the human Ying pulse accumulation. The lack of diet leads to heat in the stomach and intestines, the internal heat of fire, damp heat, phlegm and turbidity, burning the blood vessels, is an important cause of the formation of the human Ying pulse accumulation. During the development of this disease, liver and kidney deficiency and fire-heat are mutually harmful, forming the basic pathogenesis of stroke disease (cerebral infarction). The understanding of CAS in TCM should be reflected in both local and overall aspects. The accumulation of the human Ying pulse (CAS plaque) is a local change, while the fire-heat and Yin injury and the deficiency of positive energy are the overall pathogenesis. Removing the cause of the disease, adjusting the qi of the internal organs, relieving the pathogenesis of fire-heat burning veins, and eliminating the accumulation of phlegm and stagnant blood are the keys to preventing and treating the accumulation of the human-engaged veins, and thus preventing cerebral infarction and other diseases.