Stroke remains a major public health problem, and carotid artery atherosclerotic disease causes a significant proportion of all strokes. Because the U.S. population is aging, the incidence of cerebrovascular disease is increasing, and cardiologists often are involved in the care of these patients because many of them have either occult or symptomatic coronary artery disease. We review the current status of carotid and cerebrovascular diseases and therapeutic options.