A best evidence topic in cardiac surgery was written to address the question: what is the safety and efficacy of carotid artery cannulation in major aortic and redo cardiac procedures? This was measured by mortality and important complications, as well as explanations by the authors of their experience of carotid artery cannulation and how it compared to other sites of peripheral cannulation. Altogether 438 papers were found using the reported search, of which 11 represented the best evidence to answer the clinical question. As the technique is fairly underreported, a less stringent inclusion criteria was employed, yielding 7 case series and 4 case reports. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. All papers reported positive findings on this technique with low mortality and stroke rates. Based on current literature we conclude that carotid artery cannulation has been reported positively, with a good safety profile.