Bilateral carotid atherosclerosis with left-sided plaque formation is usually a combination of dyslipidemia, hypertension, genetics and other factors that combine to cause vascular damage. The most common cause of atherosclerosis is dyslipidemia, which is caused by the deposition of lipids under the endothelium of blood vessels, leading to atherosclerosis. In addition, platelet aggregation due to endothelial damage caused by high blood pressure and genetic factors is also one of the causes of atherosclerosis. The mechanism is that platelets aggregate at the endothelial damage, causing fibrin deposition to form thrombus, which is then covered by endothelial cells and forms atherosclerotic plaques within the arterial wall. Patients can alleviate the symptoms by changing bad living and dietary habits, such as proper exercise, quitting smoking and alcohol, and eating a light diet, etc. Oral lipid-lowering drugs, such as atorvastatin, can be used to stabilize plaques and reverse small plaques; and for those with severe arterial stenosis, surgical treatments are often needed to achieve the goal of curing the disease. When carotid atherosclerosis with plaque formation is found, it is necessary to complete the relevant examinations in a timely manner to clarify the cause of the disease, targeted treatment, and do not be negligent, so as not to delay the condition.