Objective To investigate the long- and short-term prognosis of patients with symptomatic carotid stenosis （SCS） after carotid endarterectomy （CEA） and related influencing factors.Methods An analysis was performed for the clinical data of 79 patients with SCS diagnosed by imaging examination in Sanbo Brain Hospital of Capital Medical University from January 2014 to December 2019， including medical history， clinical manifestations， laboratory markers， imaging findings， treatment， and modified Rankin Scale （mRS） score before and after surgery. The improvement in prognosis was analyzed at 3 and 24 months after surgery. A multivariate logistic regression analysis was used to identify related influencing factors， and a clinical prediction model was established and evaluated in terms of accuracy and predictive efficacy.Results The patients with SCS had an mRS score of 1.78±1.1 before CEA， 1.32±1.37 at 3 months after surgery， and 0.89±1.25 at 24 months after surgery， which showed a significant improvement at 3 and 24 months after surgery （P <0.01）. The multivariate logistic regression analysis at 3 months after CEA showed that myocardial infarction （odds ratio ［OR］ = 0.06， 95% confidence interval ［CI］： 0.01-0.32） and hyperlipidemia （OR = 0.13， 95% CI： 0.03-0.47） were risk factors for improvement in short-term prognosis after CEA， and the multivariate logistic regression analysis at 24 months after CEA showed that myocardial infarction （OR =0.09， 95% CI： 0.00-0.66）， hyperlipidemia （OR = 0.05， 95% CI： 0.00-0.29）， and neutrophil-lymphocyte ratio （NLR） （OR = 0.11， 95% CI： 0.02-0.50） were risk factors for long-term prognosis after CEA. The nomogram model established had relatively high accuracy and predictive efficacy.Conclusion The patients with SCS have improvement in both long- and short-term neurological function after CEA. Myocardial infarction and hyperlipidemia are influencing factors for short-term prognosis after CEA， and myocardial infarction， hyperlipidemia， and NLR are influencing factors for long-term prognosis after CEA. NLR can predict the long-term prognosis of SCS patients after CEA， and patients with low preoperative NLR tend to have a better prognosis.