Carotid artery stenosis has over the last decade been treated increasingly more often by means of angioplasty and stenting, with the indications for these interventions being gradually broadening. The authors review and analyse the results of multicenter randomized studies and registers regarding carotid artery stent grafting and carotid endarterectomy (CAVATAS, SAPPHIRE, ARCHeR, EVA-3S, CaRESS, SPACE, BEACH, CABERNET, CREATE Pivotal). Presented herein are the outcomes of management of symptomatic and symptom-free patients running both usual and high surgical risks for carotid endarterectomy. The commonly accepted criteria for surgical risks are conventionally subdivided into the absolute and relative ones (i.e., correction-prone). Carotid stenting turned out to be superior to carotid endarterectomy in patients running a high surgical risk.