Purpose Transcarotid artery revascularisation (TCAR) has emerged as an alternative carotid revascularisation strategy to carotid endarterectomy (CEA) and transfemoral carotid artery stenting (CAS). While TCAR has been rapidly adopted in North America, uptake in Australia has been limited. This review examines the evidence supporting TCAR and its potential impact on carotid revascularisation in Australia. Methodology TCAR evidence, including prospective trials and contemporary guideline recommendations, was reviewed. Factors influencing Australian adoption, including governance requirements, procedural training, patient selection and health-system considerations, were examined. Results Contemporary evidence has established TCAR as a safe and effective carotid revascularisation strategy, with perioperative outcomes comparable to CEA and favourable relative to transfemoral CAS in selected cohorts. Registry analyses and prospective studies have demonstrated low rates of perioperative stroke and death, resulting in incorporation of TCAR into contemporary carotid guidelines and treatment algorithms. Despite these developments, Australian experience remains limited. Regulatory requirements, device availability, procedural volume, funding considerations and operator training represent potential barriers to broader implementation. As local experience expands, TCAR may assume an increasing role within contemporary carotid revascularisation pathways. Conclusion Current evidence supports TCAR as an additional carotid revascularisation option in appropriately selected patients. Ongoing evaluation of local outcomes, implementation strategies and longer-term durability will help define its role within Australian vascular practice.