Objective To explore the relationship between triglyceride-glucose index (TyG) and acute ischemic stroke with large vessel occlusion (AIS-LVO) of anterior circulation. Methods A retrospective study was conducted on patients with anterior circulation AIS-LVO who underwent emergency endovascular thrombectomy at Neurovascular Center of The First Affiliated Hospital of Naval Medical University from Jan. 2018 to Dec. 2019. According to modified Rankin scale (mRS) score 90 d after operation, the patients were assigned to favorable outcome group (mRS score 0-2) or unfavorable outcome group (mRS score 3-6), and the TyG was compared. According to the median of TyG, the patients were assigned to low-TyG group (TyG＜ 8.57) or high-TyG group (TyG≥8.57), and the clinical data, laboratory indexes, and imaging characteristics were compared. Receiver operating characteristic curve was used to evaluate the predictive value of TyG for poor prognosis. Results A total of 135 patients were enrolled, with 72 in the favorable outcome group and 63 in the unfavorable outcome group. The TyG of the unfavorable outcome group was significantly higher than that of the favorable outcome group (8.82±0.63 vs 8.43±0.60, P＜0.001). There were 67 patients in the low-TyG group and 68 in the high-TyG group. Compared with the low-TyG group, the proportion of patients with hyperlipidemia history (P＝0.003), systolic blood pressure at admission (P＝0.018), fasting blood glucose level (P＜0.001), and triglyceride level (P＜0.001) were significantly higher in the high-TyG group, the infarct core volume was significantly larger (P＝0.025), the high density lipoprotein-cholesterol level was significantly lower (P＝0.013), and the mRS score 90 d after operation was significantly higher (3 ［1, 5］ vs 1 ［0, 5］, P＝0.049). The TyG had certain predictive value for poor prognosis in anterior circulation AIS-LVO patients (area under curve value＝0.662, 95% confidence interval 0.571-0.753). Conclusion TyG is elevated in anterior circulation AIS-LVO patients with poor prognosis, and may be a potential prognostic indicator for anterior circulation AIS-LVO patients.