Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are currently the most commonly used and effective treatment methods for carotid atherosclerotic stenosis. However, because of differences in operative performance, applicable population and perioperative complications between the two procedures, there has been continued controversy over the selection of treatment method. In this paper, the authors review the developmental history of this issue and summarize the results of the related controlled clinical trials.