BACKGROUND Cerebral hypoperfusion syndrome (CHS) includes a spectrum of clinical symptoms, ranging from focal neurologic deficit to intracerebral hemorrhage. CHS was initially described as a complication of carotid endarterectomy but also occurs following carotid artery stenting. This retrospective study included 320 patients treated with carotid artery stenting at 4 general hospitals in Zhejiang Province between June 2019 and June 2021 and aimed to establish a risk score for CHS. MATERIAL AND METHODS Through retrospective case analysis, a risk model and scoring model for CHS were established and evaluated. RESULTS Poor integrity of the circle of Willis, preoperative cerebrovascular resistance, mean transit time, peak time at CTP, and preoperative cerebral circulation time were significant in the univariate analysis and were entered into the regression equation to establish the logistic and additive scoring model for predicting the risk of CHS after carotid stenting. The area under the receiver operating characteristic (ROC) curve of the logistic scoring system for the early warning risk of CHS after carotid stenting was 0.964 (95% confidence interval [CI] [0.931-0.996]), and the area under the ROC curve of the CHS early risk additive scoring model after carotid stenting was 0.968 (95% CI [0.936-1.000]), The Hosmer-Lemeshow test chi-square values were 0.037 (P=0.848) and 2.671 (P=0.102). CONCLUSIONS Two methods of scoring risk for CHS were developed from a retrospective analysis of 320 patients treated with carotid artery stenting at 4 general hospitals in Zhejian Province between June 2019 and June 2021.