ABSTRACT: Advances in the management of stroke include endovascular procedures aimed at reperfusion of the occluded arteries in the brain. Although, there are no clear benefits of endovascular procedures over IV thrombolysis, endovascular procedure is most frequently employed. Depending on the institutional preferences, the procedure is carried out either under local anesthesia with conscious sedation or general anesthesia. In the absence of a prospective study, retrospective analyses have reported the better clinical outcomes with conscious sedation over general anesthesia. A meta-analysis of the retrospective studies showed higher rates of good functional outcome and recanalization and decreased rates of mortality and respiratory complications with conscious sedation compared to general anesthesia. Based on the available evidence and in the absence of a guideline, the Society of Neuroscience in Anesthesiology and Critical Care (SNACC) created a task force to provide expert consensus recommendations on the use of anesthesia during endovascular procedures. However, future prospective randomized control trials are warranted to evaluate the outcomes of retrospective studies.