Mechanical thrombectomy (MTE) in patients with acute ischemic infarct caused by large-vessel occlusion is becoming used with increasing frequency in many stroke centers. With the introduction of stent retrievers, recanalization rates >80 % are reached by most operators. However, although the technical success rate of MTE has been increased, clinical results have not improved to the same degree. In this review, the indications for MTE, the technique, and the technical and clinical outcomes are discussed. Complications and predictors for good clinical outcome are described based on recent data from the literature.