Atherosclerosis, as well as atherothrombosis and thromboembolism associated with it, are one of the most important problems of modern medicine, primarily due to their undisputed leadership among the causes of death. Carotid artery (CA) stenosis is of clinical importance because it is a risk factor for ischemic stroke. The problem of perioperative stroke is one of the priorities in cardiac surgery, as it is associated with long hospitalization, excessive surgical mortality, high "hospital" costs and changes in the quality of life. Objective: To reveal the relationship between the risk of stroke in elderly patients after CABG and the degree of stenosis of the carotid arteries. Materials and methods. The study included 112 patients with ischemic heart disease (IHD) aged 60 to 75 years. All the patient underwent a planned operation - coronary artery bypass grafting. Coronary artery disease was the reason for CABG. The observations were carried out in compliance with the Ethical Principles for Conducting Scientific Medical Research with Human Participation and in accordance with the Rules of Clinical Practice in the Russian Federation. Results. In the preoperative period, the patients observed by us, on the basis of instrumental diagnostics data, revealed a lesion of the carotid arteries. The degree of stenosis was different. We performed a gradation of the degree of narrowing of the СA lumen, namely: lesion up to 20%, 21-30%, 31-40%, 41-50%, more than 50%. Separately, we considered the degree of carotid artery disease in elderly patients before CABG and the effect of this factor on the risk of stroke after surgery. The lesion of common carotid artery (CCA) by 41-50% and more, regardless of the side of the lesion, affects the development of postoperative stroke, but the most statistically significant lesion of CCA on the left is 41-50% (p = 0.000), this fact was also confirmed by the analysis of relative risk (RR). The RR analysis confirms that the CCA lesion is hemodynamically significant by 41-50% and more, regardless of the side of localization, but the most statistically significant is the narrowing of the left CCA by 41-50% (p