Purpose Carotid surgery aims to reduce the risk of future embolic stroke in patients with severe carotid stenosis. Despite the high-risk nature of carotid surgery, vascular surgery training requires trainees to demonstrate competency in carotid intervention. Similar to other areas of vascular surgery, there has been recent concern that vascular surgery trainees have had reduced training opportunities in carotid endarterectomy (CEA) and carotid artery stenting (CAS). We aim to review the trends of ANZ vascular surgery trainee exposure to carotid surgery. Methodology A retrospective analysis was conducted using data from the Australasian Vascular Audit, between 2013 and 2023 across all vascular training centres. We analysed trainee participation in CEA and CAS, reviewing trainee role (surgeon vs assistant) and other factors that may contribute to trainee participation and development. Results In the study period, 13335 carotid interventions were performed in ANZ, 94.5% were CEA. There was a 10.3% reduction in overall carotid procedures during this period. The proportion of consultant and trainee primary operator was consistent: 49.0% and 26.2% respectively. Trainee participation remained at 49.0%. The Consultant-Trainee co-surgeon proportion increased over time, 11% to 22%. Similarly, consultant-consultant co-surgeon proportion increased in CEA and CAS from 0.32% to 0.73% and 6.7% to 14.5% respectively. Conclusion Despite the overall reduction in carotid surgery, vascular surgical trainees have had strong training opportunities and access to carotid surgery in training centres across ANZ without a significant change in participation. The increased proportion of cases with joint surgeons may demonstrate a trend to reduced autonomy in both consultants and trainees. Trainers should remain mindful of facilitating primary operating opportunities for trainees to develop competent independent practice.