Tandem occlusive lesions are responsible for up to 20% of acute ischemic stroke cases and are associated with poor prognosis if complete recanalization cannot be achieved. Endovascular recanalization might be challenging due to difficulties in the safe passage of the occluded plaque at the origin of the internal carotid artery (ICA). The balloon-assisted tracking technique (BAT), where apartially deflated balloon is exposed out of the catheter tip to facilitate its passage through stenosed or spastic arterial segments was introduced by interventional cardiologists and the applicability of the technique has been recently proposed in the field of neurointervention as well. Here we describe our experience using the BAT technique in the endovascular recanalization of tandem occlusive lesions. Procedures were performed from June 2013 to December 2020 in asingle center. Baseline clinical and imaging data, procedural and follow-up details and clinical outcomes were retrospectively collected. In this study 107 patients, median age66 years, median admission NIHSS14 and median ASPECTS8 were included. Successful recanalization of the ICA using the BAT technique was achieved in 100 (93%) and successful intracranial revascularization in88 (82%) patients. There were no complications attributable to the BAT technique. Intraprocedural complications occurred in9 (8%) patients. Emergent stenting was performed in40 (37%) at the end of the procedure. Postprocedural adverse events (intracerebral hemorrhage [ICH], malignant infarction) occurred in6 (5%) patients. Good clinical outcome at 3months (modified Rankin scale [mRS] 0-2) was54 (50%) and mortality26 (24%). Delayed stent placement during follow-up occurred in 21cases. Application of BAT technique in tandem occlusions appears feasible, safe, and efficient. Further evaluation of this technique is awaited.