Deciding whether the CAS is equal to CEA in treating patients with carotid artery stenosis is still debatable , in Egypt, despite doing both procedure, this is the 1st study to compare results of both procedures and their results without any randomization. Over 2 years we studied 70 patients divided in 2 equal groups with 35 patients doing CEA and 35 patients doing CAS with patient selection based upon the operator choice. We found that in a 6 month follow up, the CEA group had 1 patient post-operative carotid stenosis ˃ 50% with no post-operative stenosis in the CAS group with P value of 0.32. There was 1 major stroke in the CEA group with no match in the CAS group and there was 1 case of post-operative MI in both groups. Conclusion: we conclude that in Egypt, CAS has the same results as CEA with even less complications that is non-statistically significant