Carotid artery stenosis is a major risk factor for ischemic stroke. Currently, carotid endarterectomy (CEA) is the surgical treatment of choice for carotid artery stenosis. Carotid artery stenting (CAS) increases the risk of carotid artery stenosis. CAS is one of the treatment options available, particularly for high-risk CEA patients. Although CAS has the advantages of being less invasive, causing less patient discomfort, and requiring a shorter hospital stay, some patients may develop in-stent restenosis (ISR). ISR is closely related to clinical events such as transient ischemic attacks and ischemic stroke recurrence. The author examines the mechanism, influencing factors, and research progress of ISR following CAS, as well as its prevention and treatment, in order to provide clinical insights for clinicians.