Carotid is in a high risk of atherosclerosis due to its special geometric features and complex flow characteristics. Various biomechanical parameters are practical tools for carotid risk assessment. In the past half century, it has been widely accepted that oscillatory low shear environment promotes plaque formation. Based on this, more and more biomechanical indexes have been proposed, such as time-average wall shear stress, oscillatory shear index, relative residence time and so on. In this paper, multiple biomechanical parameters are introduced from the perspectives of shear stress and its temporal and spatial variation, turbulence, platelet transport and activation, stress concentration in vascular wall, etc. Their development trends are analyzed to provide a theoretical basis for more comprehensive and rapid carotid risk assessment.