Two hundred seventy-six carotid endarterectomies performed on 232 patients in a community hospital were reviewed. All the surgery was performed in a routine manner utilizing systemic heparinization and an indwelling shunt. There were three deaths in this series, giving a mortality of 1.08%. A transient neurological deficit occurred in seven patients. All of these cleared within a 7-day period; this represents 2.5%. Only one patient had a permanent deficit. Long-term followup from 6 months to 9 years showed that the majority of deaths occurred from myocardial disease and malignancies. Only eight patients later died from stroke.