Background: We evaluated the effects of stents on carotid plaque and the arterial wall using carotid ultrasound in carotid stenting patients Methods: From a carotid stent database, 30 consecutive patients were selected. All had Doppler ultrasound performed pre and post-stenting. The diameters of the lumen at the level of stenotic plaque pre and post stenting, the dorsal and ventral plaque thickness, and of the outer arterial wall diameter were measured. Plaque thickness was measured at the level of maximal stenosis.Non parametric tests were used to determine whether the stent effect and luminal enlargement were based on wall remodeling or on total arterial expansion. Results: Patient was followed for an average of 22 months. 18 patients were male, average age 70 years. 87% were symptomatic ipsilateral to the side of stenosis. The luminal diameter increased post stenting in the region of severe stenosis. Plaque thickness, both ventrally, as well as dorsally decreased post stenting, with no significant difference between the ventral and dorsal plaque effects. The measured lumen in the stent increased over time post-stenting. Conclusions: Self-expanding nitinol stents alter the baseline ventral and dorsal plaque to a significant degree, and do not significantly affect the native arterial wall and the overall arterial diameter.