Cerebro-vascular angiography has been for a long time the standard for operative decision. It has been ten years since the development of duplex scanning has allowed a non invasive approach of the diagnosis. Several authors have reported series of endarterectomy, some of them without preoperative arteriography. The authors remind us of the different arteriography procedures, their advantages and their risks and compare them to the results of duplex scanning: they admit that it is possible to do a carotid endarterectomy without preoperative arteriography. They define their indications but they are persuaded that arteriography is an excellent procedure and the rate of neurologic complications due to the technique is lower than 0.5%.