Reduction of ischaemia injury is the aim of most treatments for cerebrovascular disease. Ischemic tolerance has been demonstrated in experimental models of cerebral ischemic stroke induced by carotid occlusion. Although many strategies have proven benefit in the experimental arena, few have translated to clinical practice. We analysed endarterectomy results of 50 patients with established ischemic stroke caused by carotid stenosis. Operations were performed under the general anesthesia. Additionally, before surgical treatment in all pacients we executed remote ischemic preconditioning that included five cycles of bilateral upper limbs 5/5 min of ischemia and reperfusion alternation. Limb ischemia was induced by inflating tourniquets 200 mmHg. Despite the skeptic expectations our results prove the amelioration of cerebral hemodynamics and also improvement of total neurological deficiency of the patients according to the scale NIHSS. The tool research included: duplex scanning of extracranial arteries, CT- and conventional angiography and in some cases pre- , intra- , and postoperative neurophysiological monnitoring. Although the exact mechanism of pre- and postischemic conditioning remains uncertain, its discovery merit to address to further understanding the mecanism of endogenous neuroprotection and potential new therapeutic strategies for neuroprotection in cases of brain injury. Ischaemic preconditioning could be close to becoming a clinical technique.