Patients with severe asymptomatic carotid stenosis (SACS) are at high risk of cognitive impairment and future strokes. The basis of remote brain consequences is less well known. We investigated nodal configuration (centrality, hubs, efficiency, resilience, and wiring cost) of multimodal MRI brain connectomics in twenty-four patients with SACS and 24 comorbidities-matched controls. Our results suggest that patients with SACS is predominantly characterized by hub pathology and maladaptive pattern of network efficiency and wiring cost, following primary sensorimotor-transmodal cortical gradient. These results will contribute to a better understanding of the cognitive impairment and future cerebrovascular events in these patients with SACS.