Prospective randomised controlled trials performed in North America and Europe have demonstrated that the risk of future stroke or death is substantially reduced by performing carotid endarterectomy in symptomatic patients who have severe carotid stenosis. An audit was conducted to analyse the results of carotid endarterectomy performed during a 3-year period, at a tertiary referral vascular centre in Hong Kong. A total of 35 patients who had significant carotid stenosis underwent 36 carotid endarterectomies from October 1994 to September 1997. All patients recovered uneventfully without neurological complications or mortality. The audit showed that the current results of carotid endarterectomy at this institution fulfilled the criteria advised by the Stroke Council of the American Heart Association in 1995. Therefore, carotid endarterectomy is a validated therapeutic option for carotid stenosis in Hong Kong.