Endovascular thrombectomy (EVT) has become a major treatment step in patients with acute ischemic stroke with causative large vessel occlusion since year 2015. This document aims to provide an up-to-date, evidence based recommendations for EVT in acute ischemic stroke. The intended audiences are physicians, allied health professionals, and hospital administrators. The guideline contains four sections, including indications for EVT, imaging examination and criteria for EVT, devices and anesthesia for EVT, and post EVT care. This guideline was drafted and approved by the EVT committee of Taiwan Stroke Society.