Carotid artery stenting has gained popularity due to its minimally invasive approach. However, several design concerns preclude the successful use of carotid stents. Technical issues, such as open versus closed cells, scaffolding, trackability, foreshortening, and changes in local geometry and hemodynamics, affect stent performance. Previous clinical and experimental studies have evaluated current stent models while proposing and testing novel stent designs. This review focuses on the technical aspects of carotid stent design and the clinical significance of key design parameters identified via computational and experimental modeling.