Patients undergoing carotid endarterectomy have fragile brain function and are vulnerable to postoperative neurocognitive disorder. Cognitive dysfunction increases the risk of neurological complications. The patient had coronary heart disease, hypertension, diabetes, and renal artery stenosis. During the perioperative period, various evaluation modes were used to assess the effects of brain tissue perfusion and anesthesia on the brain function. Attention was paid to maintaining the perfusion of important organs such as the heart and brain as well as brain function, and comprehensive treatments such as anti‑inflammatopm, anti‑stress, temperature protection, and anti‑nausea and vomiting were adopted. The patient successfully completed the operation without delirium and other neurological complications.