Objective To investigate the clinical efficiency and safety of hybrid revascularization, carotid artery stenting (CAS) with simultaneous or staging coronary artery bypass grafting (CABG), for the patients with coronary artery disease and concomitant severe carotid artery stenosis. Methods From July 2008 to September 2014, a total of 274 patients with coronary artery disease and concomitant severe carotid artery stenosis who underwent CAS and CABG at the same time or within next 7 days (simultaneous operation group, n=35) or with an interval of more than 7 days (staging operation group, n=239) were recruited in this retrospective single-center study. Their clinical data and prognosis were compared and retrospectively analyzed. Results The average numbers of bypass grafts, implanted stents in the stenotic inner carotid artery and in the renal artery were significantly larger, but the duration of mechanical ventilation was obviously shorter in the staging than in the simultaneous operation groups (P<0.05). During the median follow-up for 45.6 months (ranging from 28.1 to 65.4 months), only 1 patient died after stroke. There was no significant difference in the incidences of peri-operative adverse events between the 2 groups (P>0.05). Till the end of follow-up, Cox model analysis showed that whether simultaneous surgery or not had no obvious correlation with the incidences of composite endpoints (OR=0.679, 95%CI: 0.12-3.72; P=0.66). Conclusion CAS combined with CABG is a safe and effective micro-invasive measure for the patients with coexisting coronary artery disease and severe carotid artery stenosis.