Objective:To analyze the clinical characteristics of patients with anterior and posterior circulation large vessel occlusion ischemic stroke and clinical prognoses after successful endovascular recanalization.Methods:A retrospective analysis was performed; 170 patients with large vessel occlusive ischemic stroke, admitted to Stroke Center, Second Hospital of Dalian Medical University from January 2016 to September 2022 were chosen; these patients had modified Thrombolysis in Cerebral Infarction (mTICI) 2b or 3 after endovascular treatment. These patients were divided into anterior-circulation large vessel occlusion group ( n=138) and posterior-circulation large vessel occlusion group ( n=32) according to the locations of vessel occlusion. Clinical data, parameters related to endovascular treatment, and clinical prognoses of the 2 groups were collected and compared. Results:Posterior-circulation large vessel occlusion group had significantly higher percentages of male patients and patients with atherosclerotic type (81.3% vs. 61.6%; 78.1% vs. 47.1%), significantly higher ratio of neutrophil to lymphocyte and NIHSS scores (3.78 [1.93, 10.86] vs. 2.77[1.77, 4.72]; 20.50±8.96 vs. 14.83±4.67), significantly lower percentage of patients with atrial fibrillation (21.9% vs. 58%), and significantly longer times from onset to puncture, onset to recalculation, admission to puncture, and admission to recalculation (367.50 [246.25, 630.00] min vs. 240.00 [198.75, 330.00]; 515.00 [292.50, 701.25] vs. 345.50 [270.00, 425.75] min; 163.00 [123.25, 218.50] min vs. 125.50 [97.00, 161.00]; 258.00 [200.25,389.00] vs. 219.50 [178.00, 276.25]) than anterior-circulation large vessel occlusion group ( P<0.05). The NIHSS scores 24 h after endovascular treatment, NIHSS scores at discharge, and mortality within 90 d in posterior-circulation large vessel occlusion group were significantly higher than those in anterior-circulation large vessel occlusion group (21.31±9.23 vs. 15.74±6.53; 25.5 [4.25, 40.25] vs. 10.00 [4.00, 18.25]; 40.6% vs. 20.3%, P<0.05); however, no significant differences in symptomatic intracranial hemorrhage, incidence of intracranial hemorrhage, in-hospital mortality or 90-d good prognosis were noted between the 2 groups ( P>0.05). Conclusion:Posterior circulation large vessel occlusion ischemic stroke patients have higher neurological impairment at onset than anterior circulation acute large vessel occlusion ischemic stroke patients; both patients enjoy similar results in terms of 90-d good prognosis and complications, but 90-d mortality is higher than that in anterior ones.