Objective To investigate the complications and related factors after carotid artery reconstruction (carotid endarterectomy combined with endovascular treatment) in the hybrid operating room (HOR). Methods A total of 53 patients who underwent carotid artery reconstruction in Beijing Tiantan Hospital from January 2016 to July 2016 were selected and their clinical data were retrospectively collected. The following information was obtained from medical record system: general information, operation time, intraoperative anesthesia management, postoperative complications, the length of intensive care unit (ICU) stay, the length and expense of hospitalization stay. The primary outcome was a composite endpoint, that is, the occurrence of any major postoperative complication. The secondary outcomes included the length of hospitalization stay, and the length and expense of ICU stay. EmpowerStats and R software were used for statistical analysis. Results The success rate of carotid artery revascularization was 94.3%. There were 10 cases (18.87%) of neurological complications, 4 cases (7.55%) of respiratory complications, 2 cases (3.77%) of cardiac complications, and 1 case (1.89%) of renal complications, with 13 cases (24.53%) of major postoperative complications in total. The age of patients in the postoperative complication group [median age: 67.0 (63.0‒76.0) years old] was significantly higher than that in the non‑postoperative complication group [median age: 61.0 (55.0‒66.5) years old], and the difference was statistically significant (P=0.005). The univariate analysis suggested that age may be a risk factor of major postoperative complications (P=0.010), odds ratio (OR)=1.13 [95%CI 1.03‒1.24]. The multiple regression analysis showed that after adjustment of confounding factors, age was an independent risk factor of major postoperative complications in the total intravenous anesthesia (TIVA) group, OR=1.20 (95%CI 1.02‒1.42), while age was not a risk factor of major postoperative complications in the combined intravenous and inhalation anesthesia group. Conclusions Carotid ar tery reconstruction performed in HOR has a high success rate of vascular recanalization. Age is an independent risk factor of major postoperative complications during TIVA, while age is not a risk factor of major postoperative complications in the combined intravenous and inhalation anesthesia group.