Abstract： Carotid atherosclerotic plaque increases the incidence， disability rate and mortality of ischemic cerebrovascular diseases. Although the current clinical medicinal treatment is effective，it must be taken for a long time， and has more adverse reactions. Based on the theory of "all dampness syndromes with swelling and fullness being ascribed to the spleen" in Su Wen (Basic Questions)，this paper discusses the etiology，pathogenesis and prevention of carotid atherosclerotic plaque in traditional Chinese medicine， so as to provide basis for clinical diagnosis and treatment. According to traditional Chinese medicine， the disease is due to long-going inter-conversion of phlegm and stasis caused by deficient spleen failing to transport and phlegm-damp stasis obstructing vessels. In order to achieve better clinical effect，the basic treatment is to boost qi and fortify the spleen，warm yang and transport the spleen，and dispel phlegm and dissolve stasis.