To explore the predictors of poor prognosis after endovascular treatment in patients with acute basilar artery occlusion within 24 hours of onset. Methods: We collected the demographic and clinical data of patients with acute basilar artery occlusion who underwent endovascular treatment in the Department of Neurology, Hubei Third People’s Hospital from January 1, 2016 to October 31, 2020. According to the mRS score 90 days after surgery, patients were divided into the good prognosis group and poor prognosis group. The clinical data of the two groups were statistically analyzed. Multivariate Logistic regression analysis was used to determine the independent prognostic factors of patients with acute basilar artery occlusion endovascular treatment. The ROC curve was applied to determine the best boundary value. Results: Univariate analysis showed that the differences in baseline NIHSS score, GCS score, and MRA-BATMAN score were statistically significant between the two groups. Multivariate Logistic regression analysis showed that high NIHSS score and low MRA-BATMAN score were independent factors influencing poor prognosis after endovascular treatment of acute basilar artery occlusion. ROC curve analysis showed that MRA-BATMAN score was accurate in predicting poor prognosis. The area under the ROC curve of MRA-BATMAN score predicting poor prognosis was 0.871. The best cut-off value of MRA-BATMAN score was 6.5, its specificity for predicting poor prognosis was 81.3%, and its sensitivity was 80.8%. Conclusion: High baseline NIHSS score and low DWI-BATMAN score were independent factors affecting poor prognosis in patients after endovascular treatment of acute basilar artery occlusion. When the MRA-BATMAN score was less than 6.5, the specificity of predicting poor prognosis was 81.3%, and the sensitivity was 80.8%.