BACKGROUND: Carotid stenosis is the most common cause of ischemic stroke and is managed by carotid endarterectomy. We report our ten-year results of carotid surgery for stenosis and kinking of the internal carotid artery (ICA). METHODS: Four hundred sixty nine patients underwent surgery: 306 localized carotid endarterectomy, 107 extensive endarterectomy, 18 shortening of the ICA plus endarterectomy, 42 endarterectomy plus coronary artery bypass, 11 endarterectomy plus bypass to another cervical artery, and 1 endarterectomy with aortic valve replacement. RESULTS: Three patients had an ipsilateral stroke, 2 due to technical reasons and one for a stroke in evolution. Six had transient facial nerve dysfunction, 2 division of the hypoglossal nerve and one vocal cord paralysis. Thirty-one patients died, 16 during the hospital stay and 15 during the follow up. CONCLUSIONS: The short and long-term results of carotid endarterectomy are excellent. Carotid endarterectomy remains the "gold standard" for the treatment of carotid stenosis.