Anesthesia modalities for endovascular treatment of acute ischemic stroke include general anesthesia and conscious sedation.Several recent studies have shown that the general anesthesia is associated with the poor outcome of endovascular treatment in patients with acute ischemic stroke.The underlying reason of causing worse outcome is unknown.It may be associated with hemodynamic instability and hypotension.Currently,it is considered that both general anesthesia and conscious sedation have their advantages and disadvantages.We must choose individualize anesthesia modalities for each patient before we obtain highquality evidence.