Cerebrovascular disease has become the first cause of death in China, and the incidence of stroke in China is significantly higher than the world average, adding a heavy burden to society and families. For ischemic strokes, early preventive treatment is more active and effective. Carotid endarterectomy (CEA for short) is one of the most important treatments. Carotid endarterectomy is a surgical procedure to remove atherosclerotic plaque from the lumen of the carotid artery together with the endothelium to reopen the lumen and prevent embolus dislodgement and thrombus formation, thus preventing stroke for more than 60 years. It has been proven to be safe and effective in several prospective multicenter randomized controlled studies such as NASCET, ECST, and ACAS, and is the standard treatment for carotid stenosis in the extracranial segment. In the United States, the number of CEA cases is more than 100,000 per year. In China, CEA procedures are also developing rapidly, and the number of cases is increasing. After years of summary development, the indications for CEA surgery are now very strictly regulated. CEA should be performed in patients with symptomatic carotid stenosis of more than 50%, or in asymptomatic patients with internal carotid artery stenosis of more than 70%, if there is no contraindication to the procedure, CEA can significantly reduce the probability of ipsilateral stroke. Patients with carotid artery stenosis often present with head confusion, clumsy speech, impaired limb movement, blurred vision, and decreased vision. Smoking, hypertension, hyperlipidemia, and hyperglycemia are all high-risk factors. If you have related symptoms or have high-risk factors, you should go to a qualified hospital to improve the examination and comprehensive assessment of the patient’s condition to determine whether it is suitable for surgical treatment.