In China, cerebrovascular disease has now become the first cause of death among urban and rural residents. Among them, ischemic cerebrovascular disease caused by intracranial and external stenosis of large blood vessels accounts for the largest proportion. In recent years, with the continuous development of endovascular interventional technology, this treatment technique, which originates from the peripheral vasculature, has been increasingly used for the prevention and treatment of ischemic cerebrovascular disease. Previous clinical studies have confirmed that carotid artery stenting with embolic protection (CAS) is an effective treatment alternative to endarterectomy (CEA) in a patient population with a high average risk of procedural complications. A new study (Asymptomatic Carotid Artery Disease Trial “ACT 1”) confirmed that carotid stenting was not inferior to endarterectomy in terms of death, stroke or myocardial infarction within 30 days and ipsilateral stroke within 1 year, and that there was no significant difference in stroke and death at 5 years after the procedure. Therefore, the two operations are equivalent for this population. (1) CEA or CAS may be considered for patients with symptomatic carotid stenosis of 70% to 99% (Class I recommendation, Level A evidence). (2) For patients with symptomatic carotid stenosis of 50% to 69%, CEA or CAS may also be considered (Class I recommendation, Level B evidence). (3) When endovascular intervention is performed in patients with extensive cerebral infarction, CEA or CAS may be administered after 2 weeks. For TIA, minor stroke, and non-disabling stroke, surgical or endovascular treatment within 2 weeks is more beneficial in preventing stroke recurrence (Class II recommendation, Level B evidence). (4) In patients with asymptomatic carotid stenosis ≥70%, CAS or CEA may be considered when the risk-to-benefit ratio of the patient’s surgery is fully evaluated and when the perioperative disability or mortality rate can be controlled to less than 3% (Class II recommendation, Level C evidence). (5) Patients treated with CAS should be given a combination of clopidogrel and aspirin preoperatively and both for at least 3 months postoperatively (Class 1I recommendation, Level C evidence). (6) For other secondary prevention methods, see the Chinese Guidelines for Secondary Prevention of Ischemic Stroke and Transient Ischemic Attack 2014)). (7) CAS should be performed by a surgeon or institution that can control the rate of perioperative disability or death to less than 6% (Class II recommendation, Level B evidence).