Spontaneous resolution of carotid stenosis has not been previously reported in the context of preoperative duplex ultrasound scanning, although it has been described as a recognizable phenomenon in the past. We report a case in whom significant carotid stenosis was noted at the time of listing for surgery on both duplex ultrasound and MRA. On preoperative imaging there was resolution of the lesion and surgery was avoided. This case emphasises that spontaneous resolution of carotid stenosis can occur and that preoperative duplex is useful as a prelude to surgery and can prevent unwarranted intervention.