Carotid artery mixed echogenic plaque refers to carotid artery plaque with soft and hard plaque, which is a mixed plaque, not just soft or hard plaque. If there is calcium salt deposition on top of soft plaque, part of it is manifested as hard plaque, so this condition must be treated with active medication, as well as lifestyle changes, and if necessary, surgery is needed. Before surgery, the plaque and carotid artery need to be evaluated to determine how high the risk is. If conservative treatment is adopted, the patient can be instructed to quit smoking, alcohol, low-fat diet, and take oral aspirin, resupristatin, and antiplatelet lipid-regulating drugs, which can inhibit the further development of plaque, turn soft plaque into hard plaque, and stabilize plaque. If the patient’s soft plaque is at risk of falling off, or the plaque is more serious to block the carotid artery, surgery is needed at this time.