Objective：To assess the influencing factors and the prognostic characteristics for the mismatch between Alberta Stroke Program Early Computed Tomography Score（ASPECTS）on non-contrast computed tomography（NCCT）and infarct core volume on CT perfusion（CTP）imaging in acute ischemic stroke（AIS）patients. Methods：The clinical and imaging data of 449 AIS patients with large vessel occlusion of anterior circulation who underwent NCCT and CTP evaluation from October 2019 to August 2023 were retrospectively analyzed. The RAPID software was used to automatically calculate the NCCT-ASPECTS and the infarct core volume of CTP.“NCCT -CTP mismatch”was defined as low ASPECTS with small ischemic core（LASC，ASPECTS< 6 points，CTP infarct corevolume< 70 mL）and high ASPECTS with large ischemic core（HALC，ASPECTS≥6 points，CTP infarct core volume≥70 mL）. A modified Rankin Scale（mRS）score of 0-2 at 90-day follow-up after endovascular thrombectomy（EVT）was defined as good prognosis.The multivariable logistic regression analysis were used to assess the independent influencing factors for NCCT - CTP mismatch.Results：Among the 449 AIS patients，145 patients had NCCT-CTP mismatch，and 52（35.9%）NCCT-CTP mismatch patients achieved good outcomes after EVT. The results of multivariate logistic regression analysis showed that intravenous thrombolysis（IVT）before imaging assessment（OR=1.833；95%CI：1.205-2.790，P=0.005）and higher baseline NIHSS score（OR=1.055；95%CI：1.028-1.083，P<0.001）were independent influencing factors for NCCT -CTP mismatch in AIS patients. In the subgroup analysis for NCCT -CTP mismatch patients，patients with LASC exhibited longer stroke onset time[306（219，482）min vs. 125（63，307）min，P=0.004]and a higher rate of hemorrhagic infarction（66.9% vs. 33.3%，P=0.021）after EVT than patients with HALC. Conclusions：About 35% NCCT-CTP mismatch AIS patients can benefit from EVT. The IVT using before baseline imaging and a higher admission NIHSS score were independent influencing factors for NCCT-CTP mismatch.