The main sequelae or complications of carotid artery dissection surgery are the dislodgement of emboli during or after the operation, resulting in cerebral infarction, and sometimes severe hemiplegia of the limbs. Others include postoperative infection of the incision, bleeding and so on, so it is necessary to master the strict indications in order to minimize the incidence of patients. Its indications mainly include stenosis of the carotid artery, which is generally best prevented by surgery when it reaches 70%-99%. Initially, it was believed that stenosis of the internal carotid artery with stenosis of more than 75% should be surgically removed. Studies in the last decade have shown that in addition to the above symptoms, patients at high risk of cerebral infarction, with symptomatic stenosis of 50% and asymptomatic stenosis of 60%, should undergo endarterectomy. There are also patients with frequent episodes of transient ischemic attacks, which should be actively prevented except for other factors. Also, patients who have had a stroke but have recovered well should be treated aggressively in order to prevent recurrent strokes. In addition, unstable plaques and plaques with uneven surface, uneven texture, ulcers, plaques with bleeding and other high-risk factors, which can easily lead to plaque detachment, and this time, surgery is needed to prevent it.