Objective To assess the efficacy and safety of carotid artery stenting and medical therapy in patients with symptomatic extracranial carotid stenosis ,we comparisoned and analysised clinical outcome of the two methods.Methods A retrospective analysis was conducted of a total of 265 patients with symptomatic extracranial carotid stenosis who had full follow-up data in our hospital from 2001 to 2003. 160 patients were treated by means of endovascular stent , 105 patients were received aspirin and ticlopidine. Results There was a technical success of 100% with 160 carotid arteries treated. The average stenosis rate was reduced from( 79.5 ?14.6)% before treatment to ( 11.2? 7.8)% after stent-assisted angioplasty. The diameter of carotid artery was increased from ( 1.5 ?0.6)mm to ( 4.1 ?0.4)mm (P0.05).There was 1 death in medical group,no deaths occurred in stent group. During the follow-up (mean 13.5 months) period the ipsilateral stroke rate was 0.63%(n=1),and the total stroke and death was 1.25%(n=2) in stent group. The ipsilateral stroke rate was 3.81%(n=4),and the total stroke and death was 4.76%(n=5) in medical group during the follow-up period.Conclusions Carotid angioplasty and stenting is more feasible and safe for the treatment of symptomatic extracranial carotid stenosis than medical therapy,the total perioperative stroke and mortality rate is low. At long-term follow-up,the recurrent stroke and restenosis rate is low.