Objective To evaluate the safety and efficacy of carotid artery stenting (CAS). Methods We prospectively evaluated the safety and efficacy of 76 carotid artery stenting (CAS) procedures in a consecutive series of 70 Chinese patients. This series represented a high-risk group that included patients with unstable angina, previous ipsilateral CEA, contralateral carotid artery occlusion, post-radiation carotid artery stenosis and other severe co-morbid conditions. The patients had independent neurological examinations before and after the procedure and follow-up cerebral angiography at 6 month. Results The procedural success rate was 100%. The mean carotid artery stenosis was (82± 18)% before and (5± 10)% after the procedure. During the initial hospital period and 30 days after CAS, there was no major stroke but 3 minor strokes (5.7%). No myocardial infarctions or deaths occurred during or within 30 days following CAS. At a mean follow-up of 20±12 months, 2 patients (2.8%) had asymptomatic restenosis, and 2 non-Q wave myocardial infarction. Death occurred in 2 cases, but none of them was attributed to a neurological cause. Three patients had minor strokes and no major strokes occurred during the follow-up period.Conclusion Percutaneous carotid artery stenting is feasible for performance in Chinese patients and may lower the restenosis rate.