Arteriosclerosis is a multisystem disease and the association between carotid and coronary artery disease is well known. The incidence of significant carotid stenosis in patients undergoing coronary artery bypass graft (CABG) varies from 3% to 22%. Haemodynamically significant carotid disease is present in 2.8% to 7.8% of patients. Depending on symptomatic or asymptomatic carotid disease and degree of stenosis, management of patients with concomitant coronary and carotid stenosis is very difficult. Every carotid intervention might cause some risk of stroke and myocardial infarction. There is a lack of unequivocal guidelines for patients with carotid stenosis (symptomatic or asymptomatic) requiring CABG to minimize the risk of periprocedural cardiac and cerebrovascular events.