Objective To explore the safety and efficacy of ultrasound-guided superficial cervical plexus block combined with general anesthesia in carotid endarterectomy (CEA). Methods Forty patients undergoing elective CEA were selected and divided into ultrasound-guided superficial cervical plexus block combined with general anesthesia group (combined with general anesthesia group) and simple general anesthesia group (general anesthesia group), with 20 cases in each group. We measured and analyzed the hemodynamics (invasive arterial blood pressure and heart rate), cerebral oxygen saturation, the doses of intra-operative anesthesia and vasoactive drug, post-operative visual analogue score (VAS), and one-day and three-day post-operative mini-mental state examination (MMSE) scores of the patients in the two groups at arrival to the operating room or before superficial cervical plexus block (T_0-B), after superficial cervical plexus block (T_0-L), after induction (T₁), at skin incision moment (T₂), at artery dissection moment (T₃), at carotid artery occlusion moment (T₄), at carotid artery opening moment (T₅) and two hours after operation (T₆). Results There was no significant difference in general situation between the two groups (P>0.05). In the general anesthesia group, the systolic blood pressures at T₂ and T₃ were significantly higher than that at T₁ (P<0.01), and the diastolic blood pressure, mean arterial pressure and heart rate at T₂ were significantly higher than those at T₁ (P<0.01). Except at T₄ of surgical side, the bilateral cerebral oxygen saturation at other time points in the two groups were higher than that at T_0-B, but the difference was not statistically significant (P>0.05). Compared with the general anesthesia group, the anesthesia dosage, the times of vasoactive drug and the VAS were significantly decreased in the combined with general anesthesia group (P<0.05, P<0.01), and there was no significant difference in MMSE score between the two groups (P>0.05). Conclusion The ultrasound-guided superficial cervical plexus block combined with general anesthesia can contribute to a better hemodynamic and analgesic states in CEA, and can reduce the dosage of anesthesia and vasoactive drug.