Transcervical carotid artery revascularization (TCAR) is a hybrid procedure and considered as an alternative to transfemoral carotid artery stenting (TF-CAS). The TCAR procedure involves direct access of the common carotid artery, followed by initiation of flow reversal, crossing the lesion with angioplasty/stenting of the internal carotid artery while the common carotid artery is fully clamped. Compared to TF-CAS, there is a decreased risk of stroke in both ipsilateral and contralateral hemisphere as the TCAR procedure involves neither traversing the aortic arch nor crossing the lesion unprotected. Patients with hostile necks and anatomically high lesions can be treated with a decreased risk of cranial nerve injury compared to CEA. Appropriate patient selection with respect to the lesion and access site characteristics and meticulous endovascular skills are required for technical success and achieving good outcomes.