In 2024, carotid artery stenting (CAS) has become a widely accepted, well-established treatment choice for the treatment of carotid artery disease. Major technological advancements in tools and devices to perform the procedure as straight forward as possible with the key focus on neuroprotection have significantly improved procedural efficacy and patients’ safety. Operators’ experience and skills not only in performing the actual stenting procedure but also for managing procedural complications including removal of clots form the downstream circulation are mandatory to avoid and minimize complications. Rigorous medical management in the peri- and postprocedural period, especially the use of dual antiplatelet medication, is of crucial importance to ensure best possible results. Finally, the optimization of patient selection further contributes to improve clinical outcome underlining the current significant role of CAS as complementary rather than competitive treatment choice for patient with carotid artery disease.