Objective: To evaluate the economic value of carotid endarterectomy and carotid stent implantation in the treatment of patients with carotid artery stenosis，and to provide references for clinical decision-making. Methods: Through expert interviews，the standard procedures of the two procedures were confirmed to calculate the direct medical costs of the two procedures were calculated. The initial value and range of each effect index were determined by systematic review. The decision tree model was constructed to analyze the cost-effectiveness and probability sensitivity of these two operations. Results: In all indicators，the cost-effectiveness ratio of carotid endarterectomy was lower than that of carotid stent implantation. The results of sensitivity analysis showed that in the incidence of stroke，transient cerebral ischemia，restenosis and hyperperfusion syndrome after surgery，the probability of carotid endarterectomy taking an absolute advantage over carotid stenting was more than 85 %. In terms of the incidence of local hematoma，cerebral hemorrhage and myocardial infarction after surgery，carotid endarterectomy had no absolute advantage over carotid stenting. Conclusion: Carotid endarterectomy is more economical than stent implantation. It is recommended that clinicians should use endarterectomy for treatment under full consideration of the actual condition of patients. In addition，relevant actions should be taken to actively promote carotid endarterectomy to improve the quality of life and health of patients with carotid artery stenosis.