Subclavian artery stenosis is a common type of obstructive extracranial cerebrovascular disease. Patients often suffer from vertebrobasilar artery "stealing" indirectly resulting in insufficient blood supply to the brain. Thus, a series of symptoms of the upper limb and cerebral ischemia are produced, and perioperative management is difficult. In this case, the elderly patient was complicated with hypertension and left internal carotid artery occlusion. Under general anesthesia, the left carotid subclavian bypass (CSB) was performed. The surgery and anesthesia process was smooth. The patient was cured and discharged from the hospital. We summarized the experience of this case for providing a reference for the surgical management of such kinds of patients.