Stroke is a devastating complication following coronary artery bypass grafting, which thankfully occurs with low incidence. The role of preoperative carotid ultrasound remains unclear. Whilst it is a cheap and reliable way of diagnosing carotid stenosis, it is unclear if and how this knowledge should impact on subsequent patient management. The evidence overall suggests that patients with severe carotid stenosis are likely to have an increased incidence of postoperative stroke -- however, the prevalence of severe carotid stenosis is low, and even in this cohort of patients, the incidence is not particularly high. In screened patients identified to have severe carotid stenosis, there appears to be a generally low appetite for undertaking carotid intervention internationally either prior to or concurrently with the coronary artery bypass grafting. Putting this all together, the widespread screening of asymptomatic patients would appear to not be justified.