There has been controversy over what method should be used to treat patients with asymptomatic carotid stenosis, especially the optimal medical therapy has been able to reduce the risk of stroke significantly in these patients and its efficacy is equal to or even exceed today's carotid endarterectomy or stenting. However, the treatment value of revascularization in patients with asymptomatic carotid stenosis does not completely disappear, and with the improved technologies and the prolonged follow-up time, their effects may be more apparent in reducing the risk of stroke. The optimal medical treatment can indeed significantly reduce the risk of stroke in patients with asymptomatic carotid stenosis, but it may not be able to solve all the problems. This article expounds the opinions of different authors in the treatment of asymptomatic carotid stenosis with revascularization according to the data available.