This clinical report is the first to describe angioscopy during carotid angioplasty with stent placement. The average observation time was 3 minutes 43 seconds in 18 cases. The view was clear in 67% of cases. Lesions in the endothelium, rupture of the fibrous cap, clots, debris detaching from plaque, and stent struts were observed. No symptomatic ischemic complications occurred. Diffusion-weighted MR imaging after angioscopy showed asymptomatic ischemic lesions in 47% of cases.