Stroke, the second leading cause of cardiovascular mortality, constitutes 10% of all deaths and approximately 5% of global disability-adjusted life years. A significant contributor to this burden is carotid atherosclerosis, implicated in 10–20% of ischemic strokes and transient ischemic attacks. Traditionally, carotid endarterectomy (CEA) has been the primary intervention for significant carotid artery disease, coupled with medical therapy. Reserved for symptomatic stenosis exceeding 50% and asymptomatic stenosis surpassing 70%, CEA has long been the standard approach. However, the landscape changed with the advent of percutaneous endovascular therapies, most notably carotid artery stenting (CAS), which has gained prominence since the early 1990s. While CAS has demonstrated outcomes comparable to CEA, its adoption has not reached similar levels. Despite approximately 100,000 carotid revascularization procedures annually in North America and a parallel frequency in Europe, CAS remains underutilized compared to other endovascular therapies. This chapter delves into the nuanced aspects of carotid artery stenting, addressing indications, patient selection based on clinical and anatomic characteristics, procedural techniques, and potential complications. Throughout the years, extensive research has sought to refine these elements, aiming to elevate the standing of CAS as a viable alternative in the comprehensive management of carotid artery disease.