Stroke is one of the leading causes of deaths in different parts of the world affecting individuals of different ages. it is mostly dominant among people having risk factors such drug abuse, having a background of a mild stroke, and overweight. Various approaches including carotid endarterectomy (CEA) and medical therapy have been used as mechanisms for preventing stroke particularly ipsilateral ischemia. However, there are several studies suggesting that even though CEA has the potential of reducing the risks of stroke, incidences of a high residual risk of stroke after carotid endarterectomy since Various cases of increased short-term myocardial infarction after CEA are recorded. Based on the results drawn from randomized trials comparing the effectiveness of CEA and medical therapy ,CEA provides better protection from ipsilateral strokes than the latter. The efficacy of CEA is more pronounced in patients presenting symptomatic and asymptomatic carotid artery disease. The aim of this study was to explore the comparative merits and demerits of using carotid endarterectomy and medical therapy to determine the most appropriate of the two approaches to be used in specific cases.   This research concludes that even through both therapeutic methods and carotid endarterectomy have the ability to reduce the predisposition of patients to different events of stroke, each of them have inherent limitations that must be addressed effectively to contribute to overall positive medical outcomes.