The paper discuss the surgical techniques and clinical curative effects of CEA (Carotid Endarterectomy, CEA) under a microscope via anterior cervical triangle posterior vena jugularisinterna approach combining with suspended carotid artery on the treatment of high level and complex carotid artery stenosis. Retrospective analysis was conducted on the clinical data of 21 cases of patients. The far end of carotid artery stenosis section is located above the lower edge of the second cervical vertebra centrum. The carotid artery stenosis section of three cases is located at the middle lower edge of the first cervical vertebrae. Clinical evaluation was performed from surgical process, time of postoperative drainage tube removal, perioperative complications and follow-up survey on the serious numbness at the surgical site one month, three months and six months after the surgery. There are 0 cases of postoperative death, 0 cases of cerebral hemorrhage cerebral infarction, 1 case of myocardial infarction, 2 cases of Hypoglossal nerve temporary injury, 0 case of infection of incisional wound and incidence rates of serious numbness in postoperative follow-up surgical area one month, 3 months and 6 months are 23.81%, 19.05% and 9.52% respectively. The cranial nerves and surrounding muscle groups at the far end of carotid artery stenosis and carotid artery can be fully disposed via anterior cervical triangle posterior vena jugularisinterna by utilizing microsurgery-technique and suspended carotid artery technology conveniently and completely to avoid cutting the corresponding branches of vena jugularisinterna and too much anatomy of anterior triangle lymph fatty tissue to properly avoid postoperative edema at the surgical area, cranial nerve injuries and other complications. It is a convenient, efficient, safe and effective CEA approach. .