Carotid near-occlusion is distal luminal collapse of the internal carotid artery beyond a tight stenosis. Part 2 of this systematic review focuses on prognosis and treatment and pathophysiology. Areas of confusion regarding terminology, diagnosis, and prognosis are also covered. SUMMARY: In Part 1 of this review, the definition, terminology, and diagnosis of carotid near-occlusion were presented. Carotid near-occlusions (all types) showed a lower risk of stroke than other severe stenoses. However, emerging evidence suggests that the near-occlusion prognosis with full collapse (higher risk) differs from that without full collapse (lower risk). This systematic review presents what is known about carotid near-occlusion. In this second part, the foci are prognosis and treatment, pathophysiology, the current confusion about near-occlusion, and areas in need of future improvement.