Carotid endarterectomy (CEA) is most commonly performed via conventional (cCEA)or patch (pCEA) surgical approaches. Current guidelines recommend prioritizing pCEA, however, these recommendations are based on clinical practice of over a decade ago. Under current medical conditions, controversy remains on optimal choice for surgical techniques.To compare perioperative and long-term safety and effectiveness between cCEA and pCEA.Data on baseline characteristics as well as perioperative and long-term postoperative complications from patients who underwent cCEA or pCEA at the Department of Vascular Surgery, Xuanwu Hospital of Capital Medical University, from 2013 to 2022, were retrospectively collected and analyzed.A total of 248 CEA patients included in our study. The majority of patients (87.3%) were male, and mean age was 63.6±7.6 (range, 40-81) years; 104 patients (41.9%) underwent cCEA, while 144 (58.1%) underwent pCEA. Between the cCEA and pCEA groups, there were no significant differences in clinical baseline characteristics, occurrence of perioperative or long-term (median, 42.5 [range, 7 to 120] months) complications, and survival whether restenosis-free, asymptomatic or overall.In a single-center experience, conventional and patch CEA approaches appear similarly safe and effective.Copyright © 2024 Elsevier Inc. All rights reserved.