To analyze the effect of simultaneous carotid stent placement on the prognosis of patients with anterior circulation tandem lesions. Methods: The clinical data of 287 patients with acute anterior circulation large vessel occlusion who underwent endovascular treatment were collected, in which 51 cases (17.77% ) were anterior circulation tandem lesions. Patients were divided into the stent placement group (23 cases) and non-stent placement group (28 cases) according to whether the carotid artery stent was placed in an emergency. The general patient data, treatment, and prognosis were compared between the 2 groups. Results: Compared to the non-stent placement group, the stent placement group had a higher proportion of patients with hypertension, atrial fibrillation, and smoking; the stent placement group showed a lower baseline NIHSS score and lower rate of intravenous thrombolysis treatment, and the difference was statistically significant (P<0.05). There was no statistical difference between the 2 groups in terms of sex, age, diabetes, hyperlipidemia, coronary heart disease, Alberta stroke program early CT score (ASPECTS), time between onset and hospitalization, time between hospitalization and puncture, time between hospitalization and recanalization, number of thrombectomies, successful recanalization rate, symptomatic intracranial hemorrhage, good prognosis, and death (all P>0.05). Multivariate regression analysis showed that the NIHSS score (OR=0.835, P=0.038) was a relevant factor of emergency stent placement. Conclusion: Emergency carotid stent placement does not affect the clinical prognosis of patients with tandem lesions and does not increase surgical risk.