We have experienced an anesthetic management of 56-year-old male patient with carotid stenosis. Carotid endarterectomy was performed with processed electroencephalography (compressed spectral array, CSA) monitoring. Carotid endarterectomy has significant risk of perioperative stroke and myocardial infarction. For brain protection during carotid cross clamp, body temperature of patient was maintained at 33.5oC and thiopental was infused continuously to induce burst suppression. To maintain blood pressure during cross clamp, dopamine was infused continuously and phenylephrine was injected intermittently. CSA was performed to monitor thiopental-induced burst suppression and ischemic brain insult. After releasing carotid cross clamp, body temperature was raised to 35oC.