OBJECTIVES: The overall benefit of carotid endarterectomy (CEA) is dependent on the outcome from the procedure. However, many reports are from selected centres and not population-based. The aim of this study was to assess the 30-day complication rate for a whole country and also to determine independent risk factors for serious complications. MATERIALS AND METHODS: One thousand five hundred and eighteen CEA were retrospectively reviewed, covering principally all the CEAs in Sweden, during a three year period. Indications for surgery were; minor stroke 34%, TIA 34%, amaurosis fugax 18%, asymptomatic 11% and others 3%. Data were collected from the Swedish Vascular Registry (Swedvasc). Combined cohort and case-control methodology was used. RESULTS: Registered complications were; 43 permanent strokes, 32 transient strokes (