Objective：To evaluate the clinical outcomes after mechanical thrombectomy（MT）in elderly atrial fibrillation（AF）patients with anterior-circulation large vessel occlusion（LVO）-related acute ischemic stroke（AIS）. Methods：Between January 2019 and July 2021，consecutive elderly（≥80 year）AF patients who received MT due to anterior-circulation stroke were enrolled. The primary outcome was modified Rankin scale（mRS）score at 90 days. Secondary outcomes included all-cause mortality，the recanalization status after MT（assessed using modified thrombolysis in cerebral infarction scale，mTICI）and any intracranial hemorrhage（ICH）. A multivariable logistic regression model was performed to identify predictors of the functional outcome. Results：A total of 74 eligible patients were finally enrolled. The proportion of patients with mRS score 0-2 at 90 days after stroke was 21.6%. The rate of satisfied recanalization with mTICI2b-3 was 77%. The rate of all-cause mortality and intracranial hemorrhage during 90 days after stroke was 36.4% and 35.1%，respectively. A multivariable logistic regression analysis showed that non-paroxysmal atrial fibrillation（OR=18.35，95%CI：1.98~169.77，P=0.010），baseline National Institute of Health stroke scale（NIHSS）score（OR=1.42，95%CI：1.15~1.75，P < 0.001），total procedure time（OR=1.01，95%CI：1.00~1.02，P=0.030） were independent risk factors for poor prognosis. Conclusions：MT treatment in elderly AF patients with AIS should be performed with caution，especially in those with high NIHSS scoreand/or non-paroxysmal AF. In addition，efforts should be made to improve the anticoagulant rate of elderly patients with AF to prevent stroke.