This study aims to investigate the complication and middle-term outcome of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in Chinese patients, which was a retrospective case-control study and perioperative complications and 2-year end points were analyzed. Follow-up was done by a certified doctor, and restenosis was detected by ultrasound. Operation success rate were 100% in two groups. CAS showed the higher incidence rate of all stroke/TIA at 30days post-procedure (7.89% VS 1.85%, P = 0.038), odds ratio (OR) with 95% confidence interval, 4.54 (1.09-18.97), but there was no difference in the incidence rate of stroke subgroups, mortality and myocardial infarction between two groups. The higher incidence of hypertension with CEA (14.42% VS 5.26%, P = 0.012), OR: 2.90 (1.26-6.65) and hypotension with CAS (14.91% VS 1.85%, P = 0.001), OR: 0.11 (0.03-0.42). No difference in all stroke, ipsilateral stroke and mortality between two groups at 24 months post-procedures, however, the total incidence rate of stroke/death was higher in CAS (12.84% VS 4.72%, P = 0.036), OR: 2.98 (1.08,8.23). Higher restenosis rate of CAS was examined (13.76% VS 5.66%, P = 0.045), OR: 2.66 (1.02, 6.74). CAS and CEA showed a similar middle-term outcome, but CAS showed a higher incidence rate of stroke and restenosis after operation.