Abstract: Fourty-five patients with transient ischemic attack （TIA） were treated by carotid endartere ctomy. All of them had typical manifestation of TIA and stenosis of extracranial carotid artery, verified by angiography. All but five, who experienced TIA, contralateral reversible weakness and mild hoarseness respectively, had uneventful postoperative course. There was no mortality. The role of carotid endarterectomy in the prevention and treatment of TIA, the indication and rational time of endarterectomy for TIA, and some technical factors including anesthesia, intraoperative monitoring, management of stenosis of high subcranial internal carotid artery, and postoperative care, were discussed.