While carotid endarterectomy appears to be a deceptively simple technical procedure, the meticulous detail in which the operation is carried out can spell the difference between results yielding a low operative morbidity and mortality and excellent track record for stroke prevention vs. an unacceptably high stroke rate that negates the benefit of prophylaxis. This videotape proceeds in a stepwise manner with carotid bifurcation exposure, intraoperative monitoring of the cerebral function with carotid clamping, technique of carotid endarterectomy with meticulous attention to endpoint detail, and intraoperative monitoring of the technical result of operation by completion angiography.