Objective To investigate the effects of inflation pressures on mechanical environment of pathological carotid after stent implantation. Methods The carotid artery models with lipid and calcified plaques were constructed based on high-resolution MRI images. The artery-stent interaction model was developed in the finite element software. Based on the models, the von Mises stress distributions on the vascular wall and plague under 3 different inflation pressures (909, 1212 and 1515 kPa) were simulated. Results High inflation pressure would induce large Von Mises stress on the artery-stent interface. Moreover, the stress on the lipid plaque increased significantly with the increase of inflation pressure. However, the differences in stress distributions on the calcified plaque were very small under different inflation pressure. Conclusions Higher inflation pressure may severely damage the lipid plaque and artery-stent interface after stenting, which will contribute to the failure of stent. This research finding may provide clinical guidance for the selection of inflation pressure for arterial stent deployment and the assessment of plague stability after stent implantation.