The carotid artery can be considered as the lifeline of a person because it can cause very serious consequences if it is narrowed or blocked. According to statistics, most ischemic strokes are caused by carotid artery stenosis in clinical practice. In addition, carotid stenosis may also manifest as dizziness and headache, insomnia and sleeplessness, and weakness. Many patients may also experience transient cerebral ischemia, resulting in causing transient local neurological dysfunction. Mild stenosis (less than 50%) can be controlled with medications to prevent or delay cerebral infarction; however, if the stenosis reaches moderate (50%-70%) or severe (greater than 70%) surgery should be performed as soon as possible even if there are no symptoms. The main surgical treatment options for carotid stenosis are carotid stenting and carotid endarterectomy, and carotid endarterectomy is superior in terms of treatment effectiveness and safety. This procedure was widely used in Europe and the United States in the early days, but medical workers in China did not know much about it, which restricted its application, so not many of them were done in China. Later, some scholars introduced it into China and continuously improved and upgraded it to give full play to its effect, and now it has become a standard procedure for the treatment of carotid stenosis. The principle of carotid endarterectomy is to make a 6-8 cm incision in the neck under a microscope, find the carotid artery to temporarily clamp the distal and proximal ends of the carotid artery, then cut open the carotid artery, peel off and excise the diseased intima, so that the inner wall of the carotid artery is smooth and the inner diameter returns to normal size, and the operation takes 1-2 hours. The procedure requires a high degree of clinical experience and the surgeon must be able to deal with all possible risks during the operation. Patients are advised to choose the right hospital and the right doctor, and to actively pursue treatment without delay.