Previous research has indicated that intraplaque hemorrhage is a significant pathogenetic factor in carotid artery disease. The present study was undertaken to evaluate whether the clinical presentation of patients with carotid artery disease could be correlated to quantitative histologic analysis of surgically removed carotid specimens. Two-hundred-seventy patients undergoing carotid endarterectomy comprised the material. Symptomatology was assessed preoperatively. After removal, the carotid plaques were analyzed histologically for relative volume content of hemorrhage, fatty tissue, fibrous tissue, and calcification. There was no difference between asymptomatic and symptomatic patients. However, when the time interval between onset of symptoms and surgery was considered, plaques from patients with recent symptoms contained more hemorrhage compared with plaques from asymptomatic patients (p = 0.0045). The paper supports the theory of intraplaque hemorrhage being related to clinical events in carotid artery disease.