Between May, 1969, and December, 1985, 680 carotid endarterectomies were carried out in the Surgical Professorial Unit in St. Vincent's Hospital, Sydney. Recurrence requiring re-operation was detected in nine arteries in seven patients. Continued smoking after the initial operation may have contributed to the restenoses. The origin of the internal carotid artery was the most common site of recurrence, irrespective of whether restenosis was caused by myointimal fibroplasia or recurrent atheroma.