Aim. The article presents the results of surgical treatment of patients with coronary artery disease and bilateral carotid artery stenosis. Material and methods. In the Aortic Surgery Department (Cardiac Surgery Department №1) of FSBSI Petrovsky Russian Research Center of Surgery of Moscow from January 2005 to November 2015 it was performed 1020 procedures of myocardial revascularization in patients with ischemic heart disease. Sixty seven (6,6%) of them had bilateral hemodynamically significant atherosclerotic stenosis of carotid arteries (≥70%). All patients underwent one-stage reconstruction of carotid (unilateral) and coronary arteries with subsequent reconstruction of the contralateral ICA within 1 month. Indications for surgery were stenosis >70%. Reconstruction side and need for internal shunt were determined using data of hypercapnic test in TCD. So the choice of intervention side depended on the collateral circulation reserve in both sides. In another words surgery was conducted on the side with significantly reduced or depleted collateral reserves. Results. Overall surgical mortality was 1.5%. There were no cases of myocardial infarction or stroke in the early postoperative period. Conclusion. Our data point on overestimation of surgical risk reflected in the literary sources for this treatment strategy. One-stage surgical treatment of patients with coronary artery disease and bilateral carotid stenosis is associated with high efficiency and safety if necessary surgical experience is presented.