Stroke is the one of the commonest causes of death in the world after coronary heart disease and all cancers. About 80 percent of all first ever in life time strokes are ischaemic, 10 percent are due to primary intracerebral haemorrahge and in the remainder there is uncertainty. Stroke remains a major complications of atherosclerotic cerebrovascular disease, with extracranial carotid occlusive disease accounting for nearly one third of all events. Diagnosis and management of carotid arterial occlusive disease and its ensuring comorbid illnesses have been the focus of extensive debate during the past two decades. Following the favorable results obtained in treatment of coronary artery disease, combined angioplasty and stenting has been advocated for treatment of carotid stenosis as well. The results of early series have suggested that endoluminal revascularization in high risk patients can be performed with an acceptable degree of safety.