As with other minimally invasive surgical procedures, carotid angioplasty and stenting (CAS) has developed rapidly over the last decade. Although many believe equivalency with carotid endarterectomy has been established in high-risk patients, the effectiveness of CAS in lower-risk patients is not yet established. This report aims to provide a comprehensive and critical review of the trials and registries of CAS and to offer insight into future directions of this emerging technology.