Since carotid artery stenting was introduced into clinical practice as an alternative treatment option for significant carotid artery stenosis, several randomized trials have been published with different minimum requirements for the treating interventionalist and therefore different event rates. Analysis of large single center studies and registries has shown a significant decrease in event rates with an increase in experience in carotid artery stenting techniques. The randomized trials with exactly defined minimum requirements including a reasonable number of prior carotid artery interventions showed comparable results between carotid artery stenting and surgical approaches.