Carotid artery atherosclerosis remains one of the major causes of stroke. The efficacy of carotid artery recanalization has already been established and is considered significant for symptomatic stenosis >70% and moderate for stenosis between 50-69 %. Regarding asymptomatic stenosis, carotid artery recanalization should be reserved for carefully selected patients with a stenosis between 70-90 % and an estimated procedural risk at less than 3 %. Two therapeutic options are currently available : angioplasty with stent placement and endarterectomy. While the endovascular approach may be associated with a higher periprocedural complication rate of stroke, there remains a significant decrease in the rate of myocardial infarction and peripheral nerve palsy compared to surgery. As a result, each case should be reviewed with a multidisciplinary approach in order to propose the best therapeutic strategy.