Objective: To evaluate the methods for revascularization in Riles type 1A common carotid artery occlusion (CCAO) and the efficacy. Methods: From August 2012 to September 2015, 9 patients underwent revascularization for Riles type 1A CCAO. Of the patients, 5 cases underwent bypass graft and 4 cases underwent in situ reconstruction. Results: Operations were successfully completed in all patients, and their symptoms disappeared or were significantly improved after operation. Two patients (2/9) developed hyperperfusion syndrome that improved after strict blood pressure control and reducion of intracranial pressure by cerebral dehydration, and no serious complications such as cerebral hemorrhage occurred. During follow-up period, patients were generally in good condition and their symptoms were significantly improved or disappeared; at 6 months after operation, mild to moderate proximal in-stent stenosis (<50%) was found by ultrasound in one patient who had combined carotid endarterectomy and carotid artery stenting, but the patient had no subjective symptoms and no treatment was given; one patient with coronary artery disease died due to myocardial infarction 17 months later. Conclusion: Revascularization in Riles type 1A CCAO is safe and effective; the surgical treatment should be individually tailored and the in situ reconstruction should be recommended in qualified medical institutions.