To investigate the safety and effectiveness of mechanical thrombectomy in the treatment of distal medium posterior cerebral artery (PCA) occlusion. Methods: A total of 26 patients with occlusion in the P2 and P3 segments of the PCA who underwent endovascular interventional therapy at Wuhan First Hospital from September 2017 to January 2023 were included. A retrospective analysis was conducted on patients' general characteristics, vascular risk factors, National Institutes of Health Stroke Scale (NIHSS) scores at admission, posterior circulation ASPECTS scores at admission, preoperative intravenous thrombolysis, occlusion sites, time from onset to puncture, time from puncture to revascularization, postoperative modified Thrombolysis In Cerebral Infarction (mTICI) grades, NIHSS scores at discharge, modified Rankin Scale (mRS) scores at 90-day follow-up, and incidence of intracranial hemorrhage and mortality within 90 days postoperatively. Results: Among the 26 patients, 17 (65.4% ) achieved immediate complete revascularization (mTICI grade 3) postoperatively, and 23 (88.5% ) achieved successful revascularization (mTICI grade ≥ 2b) immediately after surgery. Four patients (15.4% ) died within 90 days postoperatively, one patient (3.9% ) experienced symptomatic cerebral hemorrhage postoperatively, and 16 patients (61.5%) had mRS scores ≤ 2 at the 90-day follow-up. Conclusion: Mechanical thrombectomy demonstrates acceptable safety and effectiveness in the treatment of acute PCA occlusion stroke.