Objective. To evaluate the possibility of acupuncture, as an element of preoperative preparation of the patient to carotid endarterectomy, for increasing the tolerance of patients with brachiocephalic stenosis to cerebral ischemia. Material and methods. We studied 40 inpatients with low tolerance to carotid compression test. Ultrasound examination of brachiocephalic and intracranial blood flow was carried out, including carotid compression, apneic and hyperventilation tests. We examined 20 people from the control group before traditional medicinal treatment as well as after first and second therapeutic courses; 20 patients from the main group were tested before and after medicinal treatment, and after acupuncture course. Results. We couldn't identify any significant changes in cerebral hemodynamic reserve in patients with severe carotid stenosis after medicinal therapy; at the same time we registered its reliable 2.16 fold growth after acupuncture treatment. Conclusion. Аcupuncture treatment leads to cerebral hemodynamic reserve growth in most patients with significant brachiocephalic stenosis. The inclusion of acupuncture in therapeutic complex improves the quality of preoperative preparation to carotid endarterectomy and its tolerability.