The elderly population has the highest risk for developing stroke and the annual death rate is some 394/100000 popu lation. Moreover, the elderly are the fastest growing segment in our society. In carefully selected patients carotid endoar terectomy may provide to profilaxis against stroke. With a careful selection, acceptable low operative moratlity and morbidity rates may be achieved, comparable to the 4.3% and the 2.3% of the Veterans Affair and ACAS studies, in which the patients mean ages were 64.1 and 67 yesars respectively.