Patch angioplasty with carotid endarterectomy has been advocated to decrease the incidence of recurrent stenosis and postoperative acute occlusion. In this article, we describe our experience with 35 carotid endarterectomies using the Hemashield patch graft. The technique is simple and does not require any special preparation of the patch material. The Hemashield is placed over the arteriotomy and cut to the exact length of the opening. Each end of the patch is then anchored to the arteriotomy with double-armed 6-0 prolene or pronova. The other steps of carotid endarterectomy are unchanged, and the same suture can be used for patch placement. The 30-day major mortality/morbidity rate was 2.8% (1 patient died of postoperative cerebral infarction). There was no postoperative occlusion. We also introduce 3 representative cases treated with a Hemashield patch graft. This patch graft is useful for safer carotid endarterectomy.