Background: Carotid artery stenting (CAS) is emerging as a reasonable alternative to carotid endarterectomy especially for patients with comorbidities. However, this endovascular approach has acute complications related to distal embolization. Therefore, the use of protection devices is expected to reduce the risk of embolic strokes during the procedure and deliver more favorable outcomes. We report our early experience of balloon occlusion and filter type distal protection devices in CAS. Methods: CAS was performed in 92 lesions of 73 patients (age 61.0짹12.7 years, male 71.2%). Of these patients, 16 patients with 17 carotid lesions underwent CAS using distal protection devices. A balloon occlusion type protection device, PercuSurge GuardWire system, was used in 8 lesions and a filter type, FilterWire EX system, in 9 lesions. Procedural and early clinical outcomes including complications were compared between two groups of patients who underwent CAS with distal protection (group I) and without distal protection (group II). Results : Carotid angioplasty and stenting was performed successfully in all patients. Successful deployment of protection devices was possible in all 17 carotid lesions. Among the 75 carotid lesions treated without protection device, there were two fatal strokes, one non-fatal major stroke, one minor stroke and five transient ischemic attacks (TIA), whereas one TIA and one non-neurologic death occurred among 17 lesions treated with protection device (p=ns). Conclusions : CAS with use of distal protection device can be performed successfully and safely. Despite limited experience of protection devices, our result suggests the use of distal protection device in carotid intervention may reduce acute complications related to distal embolization during the procedure.