Objective To summarize the preliminary experience of endovascular recanalization in treating chronic symptomatic internal carotid artery occlusion.Methods Four patients with chronic symptomatic internal carotid artery occlusion,admitted to and underwent endovascular recanalization in our hospital from August 2013 to August 2014,were chosen in our study; their clinical data were retrospectively analyzed.Results Four patients were successfully opened the internal carotid arteries;cerebral CT angiography showed that all arteries were unobstructed.One appeared intra-operative iatrogenic internal carotid artery cavernous sinus fistula,and successful occlusion of the fistula with internal carotid artery patency was achieved after one week.Three months after the operation,two showed unobstructed internal carotid artery by DSA and the other stated no abnormalities during the telephone follow up.Conclusion Endovascular recanalization is a safe and effective treatment method for chronic symptomatic internal carotid artery occlusion.