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Background: Patients suffering from a concomitant coronary and carotid artery occlusive disease represent a high‐risk population whose management remains controversial. Methods: Between April 1979 and June 2002, 202 patients (163 men and 39 women, mean age 65 ± 7 years) were admitted at the Department of Cardiovascular Surgery of the University of Bologna for coronary artery bypass graft and carotid endarterectomy (CEA). In Group 1 (140 patients) coronary artery bypass graft and carotid endarterectomy were performed simultaneously while in Group 2 (62 patients) they were performed as two‐staged procedures. Results: The rate of postoperative stroke was 6.4% in Group 1 (9/140) and 4.8% in Group 2 (3/62). Significant univariate predictors of myocardial infarction were smoking history and previous myocardial infarction; for stroke they were older, greater than 70 years, and a smoking history; for …