Objective To explore the impact of different treatment methods on the prognosis of patients with acute ischemic stroke with large vessel occlusion (AIS-LVO) of anterior circulation after endovascular treatment. Methods Patients with AIS-LVO of anterior circulation who received endovascular treatment in Neurovascular Center, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2019 to Jun. 2021 were retrospectively enrolled. The patients were divided into directly admitted group and transfer group based on their treatment methods. The patients in the directly admitted group were directly admitted to our emergency department through the 120 emergency system or other transportation, while the patients in the transfer group were transferred to our emergency department through the 120 emergency system from other hospitals. The baseline data, treatment process and postoperative outcome indicators after endovascular treatment were analyzed between the 2 groups. Results A total of 239 patients were enrolled, including 129 patients in the directly admitted group and 110 patients in the transfer group. Compared with the directly admitted group, the transfer group had a higher proportion of pre-hospital warning, a higher baseline National Institute of Health stroke scale score, a larger core infarction volume, and a lower Alberta Stroke Program early computed tomography score (all P<0.01). The onset-to-door time, onset-to-puncture time and onset-to-recanalization time in the transfer group were longer than those in the directly admitted group (258[175, 373] min vs 94[60, 176] min, 354[284, 494] min vs 225[162, 318] min, 417[340, 577] min vs 277[205, 424] min; all P<0.001), while the transfer group had shorter door-to-puncture time and door-to-recanalization time (94[75, 127] min vs 103[86, 139] min, 151[115, 193] min vs 162[133, 217] min; both P<0.05). The proportion of 90-d good prognosis in the transfer group was only 49.1% (54/110), significantly lower than 63.6% (82/129) in the directly admitted group (P=0.024). Meanwhile the transfer group had a higher proportion of symptomatic intracranial hemorrhage and a higher mortality (14.5%[16/110] vs 6.2%[8/129], 20.0%[22/110] vs 10.1%[13/129]; both P<0.05). Conclusion For patients with AIS-LVO of anterior circulation who received endovascular treatment, the transfer group patients have more severe stroke, higher incidence of symptomatic intracranial hemorrhage, higher mortality and lower 90-d good prognosis.