The European Society for Vascular Surgery (ESVS) has released the 2023 edition of "Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease", providing a comprehensive and detailed descriptions of diagnostic and therapeutic strategies for carotid and vertebral artery disorders. The guidelines consist of a total of 133 recommendations, among which 11 recommendations have been revised in terms of evidence grades or recommendation strengths, and 38 are newly introduced recommendations. Atherosclerotic carotid and vertebral artery stenosis are critical contributors to ischemic stroke, and a rational management and treatment strategies can reduce the risk of stroke. Therefore, the authors, based on the information from evidence-based medicine in the guidelines and considering the clinical practices in our country, interpret the content of the guidelines with the aim of assisting healthcare professionals in better managing patients with atherosclerotic carotid and vertebral artery diseases.