Carotid artery stenosis is the most common cause of ischemic cerebrovascular disease. Carotid endarterectomy (CEA) is superior to pharmacological treatment in reducing the risk of stroke and was once considered the gold standard for the treatment of carotid artery stenosis. However, in the last 20 years, rapid advances in interpositional technology and materials science, especially with the use and improvement of cerebral umbrellas, have made carotid artery stenting (CAS) an important treatment for carotid artery stenosis. Compared to carotid endarterectomy, carotid stenting has a broader range of indications. It avoids the need for a surgical incision in the neck and its complications such as cranial nerve damage and hematoma compression. It requires only a femoral artery puncture under local or light general anesthesia, a cerebral umbrella is prepositioned distal to the carotid stenosis, and a metal stent is implanted into the stenotic carotid artery to support the stenosis and allow blood flow. Thus, it is less invasive and has a faster recovery. For patients who cannot tolerate carotid endarterectomy due to poor physical condition, this procedure can still be considered. In addition, it is a good indication for stenting in cases of restenosis after carotid endarterectomy, carotid stenosis near the skull base that makes the procedure more difficult, and carotid lesions caused by radiation. In conclusion, carotid artery stenting is a safe and effective method for treating carotid stenosis. Of course, it has its shortcomings: it is more expensive; it is also associated with stroke, hemiparesis, and even life threatening; in some cases, the carotid stenosis is so severe that the delivery device cannot pass through; and it also has problems such as restenosis. Therefore, whether stenting or surgery, the appropriate treatment should be chosen according to the patient’s specific situation.