Objective: The impact of advanced age on the safety and efficacy of carotid artery stenting (CAS) is controversial. The aim of this study was to retrospectively evaluate the safety of CAS in the elderly. Methods: In total, 111 patients (119 procedures) from October 2008 to November 2011 were included; of these, 28 patients (31 procedures) aged <70 years, 49 patients (52 procedures) were septuagenarians, and 34 patients (36 procedures) were octogenarians. The primary outcome event for the analysis was any stroke within 30 days after CAS. The secondary outcome event was new diffusion-weighted imaging (DWI) lesions on the day following stenting. Results: The incidence of stroke was 3.4% (4 of 119 procedures; two in the <70 years of age, one in the septuagenarians, and one in the octogenarians). The incidence of new DWI lesions immediately after CAS was 17% and was highest in the group aged ≥80 years. Conclusion: Advanced age alone does not exclude adequate CAS, but care must be taken regarding plaque vulnerability at the target site and atherosclerotic change of the access route.• Key words • carotid artery stenting, carotid artery stenosis, age Correspondence Address: Jun MORIOKA,