In the present work, blood flow through a patient‐specific carotid bifurcation is thoroughly analysed. A locally conservative Galerkin spatial discretization is applied along with an artificial compressibility and characteristic‐based split scheme to solve the 3D incompressible Navier–Stokes equations. Boundary layer meshes are introduced to accurately resolve high near‐wall velocity gradients inside a patient‐specific carotid bifurcation. A total of six haemodynamic wall parameters have been brought together to analyse the regions of possible atherogenesis within the domain. The results show that wall shear stress (WSS) is high (6–15 Pa) near the apex, along with a small region where WSS exceeded 20 Pa. This peak WSS region is close to the inner wall of the external carotid artery (ECA). It is also clear from the results that low WSS occurred in the common carotid artery (CCA). High oscillatory shear occurred in the CCA distal to a local narrowing of the internal carotid artery and along the outer wall, indicating a potential region of atherogenesis. The highest values of wall shear stress angle deviation and wall shear stress angle gradient occur at the apex. The wall shear stress temporal gradient reached 4000 Pa/s near the apex, closer to the ECA. Wall shear stress spatial gradient distribution corresponded with the WSS distribution, with a maximum occurring at the apex. Copyright © 2010 John Wiley & Sons, Ltd.