Abstract    BACKGROUND: Carotid endarterectomy (CEA) is recommended in patients with symptomatic and some times asymptomatic carotid stenosis in vascular surgery centers with low perioperative complication rate.    METHODS: A stenosis retrospective study was carried out in patients underwent CEA in 3 vascular surgery centers in Tehran and 2 centers in Mashhad. Patients’ selection criteria, methods of detection of carotid stenosis, method of anesthesia, surgical techniques and perioperative complications were evaluated.    RESULTS: Overall, 388 CEA in 345 patients (65% males) with mean age of 66.8 year old (ranged 46-84 years) were evaluated. Detection of carotid stenosis was made by one carotid duplex ultrasound in 90% of CEA candidates. The whole perioperative stroke death rate in reported Iranian vascular surgery centers is 6.4%. Perioperative stroke death rate in Imam Reza, Razavi, Shohaday Tajrish, Taleghani and Iranmehr hospitals was 2.4, 0, 4.8, ,10.2 and 10.2 percent, respectively.    CONCLUSION: In Iran, CEA is recommended only in patients with symptomatic ≥ 70% internal carotid arterystenosis and preferably in patients with symptomatic ≥ 90% stenosis. Method of detection of carotid stenosis in Iranian vascular surgery centers should be corrected.      Keywords: Carotid, Endarterectomy, Iran.