Atherosclerotic disease of the carotid arteries is responsible for asignificant portion of ischemic strokes. Carotid endarterectomy (CEA) iscurrently the accepted standard of treatment for patients with severesymptomatic carotid stenosis. In the past few years, however, carotidangioplasty and stenting (CAS) has emerged as a potential alternativeendovascular treatment strategy for this disorder, and many randomizesstudies showed that CAS is not inferior to CEA, however data from thesestudies do not justify a blind enthusiasm for CAS and it is better to look for both CAS and CEA as complementary procedures and each caseshould be evaluated on an individual basis.The aim of this work is toreview the outcome of carotid endarterectomy versus carotidangioplasty and stentingand to present the outcome of some casesdone at Kasr Alainy hospital. Six patients were included in the study andweresustaining events of cerebral ischemia confined to the ipsilateralinternal carotid artery, with stenosis more than 70% of arterial lumen,whether symptomatic or asymptomatic. Either endarterectomy orangioplasty and stenting was done for each patient randomly andpatients were followed up both radiologically and clinically for 12months. The results showed that carotid stenting is equivalent to carotidendarterectomy in reducing carotid stenosis without increased risk formajor complications of death/stroke or restenosis.