The key to treating acute ischemic stroke (AIS) lies in promptly reopening the blocked blood vessels to salvage the ischemic penumbra. The DAWN and/or DEFUSE-3 trials extended the time window for endovascular treatment of AIS from 6 hours to 24 hours. However, high resource requirements, high radiation exposure, contrast-induced nephropathy, and prolonged examination times limit the practical application of multimodal imaging screening protocols. Increasing evidence suggests that non-contrast computed tomography (NCCT) scan-based imaging criteria may be safe and effective in selecting patients with AIS and large vessel occlusion for endovascular treatment (EVT). This article reviews the research progress on preoperative imaging assessment based on NCCT scan for endovascular treatment of acute ischemic stroke, from four aspects: early time window, extended time window, overtime window, and endovascular treatment for large core infarcts.