To explore influencing factors of poor outcomes of anterior circulation large artery occlusion (AC-LAO) after endovascular therapy (EVT). Methods: Retrospective analysis was made on the clinical data of 145 patients with AC-LAO who were successfully recanalized after endovascular treatment. According to the modified Rankin scale (mRS) scores 90 d after surgery, patients were divided into the good prognosis group (mRS score ≤ 2）and poor prognosis group (mRS score＞3). Univariate analysis was performed on baseline data, neurological status, risk factors, Rapid software evaluation, angiographic parameters, and other data of patients in the two groups. Multivariate Logistic regression was used to explore the independent factors influencing poor prognosis after recanalization following endovascular treatment. Results: Among the 145 patients with recanalization, 65 had an mRS score＞3 after surgery, and the poor prognosis rate was 44.83% . Multivariate Logistic regression showed that a high NIHSS score (OR 0.866, 95%CI 0.794～0.943, P=0.001), low Aspect score (OR 1.607, 95%CI 1.181～2.186, P=0.003), and poor lateral vascular circulation (OR 0.373, 95% CI 0.163～0.856, P=0.020) at the time of admission were independent risk factors for poor prognosis. Conclusion: For AC-LAO patients, the NIHSS score, Aspect score, and collateral circulation status at the time of admission are independent risk factors for poor prognosis early after recanalization.