Introduction: There is increasing incidence of carotid artery stenosis in Korea. But the accessibility to carotid endarterectomy is so limited that carotid artery stenting is being considered a good alternative therapeutic modality. Methods and Results: Carotid artery stenting was started on March 2004 and 41 patients was done carotid artery stenting until July 2008. Thirty-seven (90.2%) patients were symptomatic (stroke 34 (82.9%), transient ischemic attack 3 (7.3%)) and 4 (9.8%) patients asymptomatic but scheduled to undergo CABG. Success rate was 97.5% and a failure was due to difficulty in guiding catheter engagement in a patient with type III aortic arch. Distal protection device was used in all patients. Post-stent brain diffusion magnetic resonance image was done in 39 patients (95.1%). There were new high intensity signals found in ipsilateral (25, 65.8%) and contralateral (6, 15.8%) hemispheres and four of them had transient neurologic deficits (14.3%). There were acute complications in 7 patients (17.5%). Four patients (10.5%) showed transient neurologic deficit and no major ischemic stroke occurred. But hemorrhagic infarction occurred in 3 patients (7.5%) and one of them died (2.5%). There were 1 minor ipsilateral stroke (2.5%) within 1 month and 2 minor strokes (5%, 1 ipsilateral and 1 bilateral) after 1 month. Conclusion: Carotid stenting with distal protection device was feasible in treating carotid artery stenosis and safe in preventing major embolic complications. Hemorrhagic stroke is a rare but serious complication after carotid artery stenting and its predictors or risk factors should be revealed with further investigation.