Objective To study the clinical value of carotid endarterectomy in the treatment of symptomatic internal carotid artery stenosis.Methods The clinical data of 23 patients with symptomatic internal carotid stenosis undergoing carotid endarterectomy and followed up from June 2012 to June 2014 in our hospital were analyzed retrospectively.Results After operation, temporary hoarseness and multiple small infarct foci occurred in one case, respectively, and two cases of neck hematoma recovered after conservative treatment; there were no severe complications such as limb paralysis and impaired consciousness. Computed tomography angiography and digital subtraction angiography showed patency of the carotid artery. There were no symptoms of vascular restenosis and severe cerebral ischemia during the follow up for 6 months to 2 years.Conclusions Carotid endarterectomy for the treatment of symptomatic carotid stenosis is simple, safe, and effective.