Patch angioplasty of the carotid artery after endarterectomy is a widely utilized technique with potential benefits of perioperative and long-term stroke risk reduction as well as a decreased incidence of recurrent stenosis. One of the complications of using a synthetic material as a patch is the development of prosthetic patch infection. We present a case report of a patient who was treated at our institution with such a complication and review the literature on this rare occurrence. The risk factors, workup, diagnosis, and treatment of prosthetic patch infection are reviewed. Despite the serious nature of this problem, surgical treatment is associated with minimal morbidity and an acceptable postoperative mortality and stroke rate.