Objective To investigate the incidence and associated risk factors of post-stroke epilepsy(PSE)following endovascular treatments for acute ischemic stroke(AIS).Methods This retrospective study enrolled patients with AIS who underwent endovascular treatments at the Department of Neurology,Xijing Hospital,Air Force Medical University from January 2019 to December 2023.Patients were divided into PSE group and non-PSE group based on the occurrence of PSE.Demographic characteristics,TOAST classification,stroke severity,intracranial lesion characteristics,details of endovascular treatments,complications,and prognosis were compared between the two groups.Multivariate Cox regression analysis was used to evaluate the risk factors of PSE.Results A total of 197 patients with AIS who underwent endovascular treatments were analyzed,with a median follow-up time of 16(12,24)months.PSE occurred in 16 patients(8.1%),with a median time to the first late seizure of 8(6,12)months after stroke.The proportions of PSE group in the history of atrial fibrillation,lesion involvement in the frontal,temporal,and insular lobes,cortical involvement,and postoperative hemorrhagic transformation were higher than those of non-PSE group(P<0.05).The proportion of patients with a good prognosis(mRS≤2)was lower in the PSE group(37.5%vs 67.4%,P=0.016).Multivariate Cox regression analysis identified infarct volume exceeding 2/3 of the blood supply area of large vessels(P=0.013)and early seizures(P<0.001)as independent risk factors for PSE after endovascular treatments.Conclusion For patients with AIS receiving endovascular treatments,especially those with larger infarct volume and early seizures,the occurrence of PSE should be highly vigilant.The occurrence of PSE is often associated with poor neurological outcomes.