In recent years, the field of neuroendovascular surgery has burgeoned with new techniques and devices which have revolutionized patient care. Endovascular revascularization is one of the central pillars of neurointervention which can broadly be defined as the minimally invasive restoration of blood flow to the cerebral vasculature. Conceivably, the most pivotal breakthrough in this field concerns the treatment of patients suffering from acute ischemic stroke (AIS). This chapter begins by providing a technical and historical overview of stent retriever technology along with the pivotal early window randomized clinical trials (RCTs). The extended time window for patients with large vessel occlusion (LVO) of the anterior circulation is subsequently reviewed with particular emphasis on radiographic selection criteria and perfusion imaging. Next, we discuss the large core trials which have further increased the pool of eligible patients. Lastly, results from the most recent RCTs concerning mechanical thrombectomy (MT) for occlusion of the basilar artery are summarized. By the conclusion of the chapter, the reader will better understanding the role endovascular revascularization for AIS.