Introduction: Anemia at presentation is associated with worse outcomes in patients with acute ischemic stroke. We aim to investigate the association of anemia upon presentation with functional outcomes in patients who undergo mechanical thrombectomy (MT). Methods: We performed a retrospective chart review of patients who underwent MT for anterior circulation large vessel occlusion at a comprehensive stroke center from 7/2014 to 5/2020. Anemia was considered a dichotomous categorical variable with a cutoff point of hemoglobin <12.0 g/dL in women and <13.0 g/dL in men, as per the definition of the World Health Organization. A binary logistic regression analysis was performed, controlling for age, pre-treatment-NIHSS, ASPECTS ≥6, TICI score ≥2b, onset to recanalization time, and administration of intravenous-alteplase (IV-rtPA), with the presence of anemia as the predictor. The primary outcome was a good functional outcome at 3-months (mRS of ≤1). The secondary outcomes were 3-month mortality, sICH (ECASS-II criteria), and infarct volume on follow-up CT Head. Results: 177 patients met our inclusion criteria. The mean age was 64.34±15.16 years. 93 (52.54%) patients were men. 34 (19.21%) patients had 3-month mRS≤1. 11 (6.21%) patients developed sICH. Among men, there was a significant association of anemia with lesser chance of good functional outcome (5.89% vs.23.73%; OR, 6.1; 95% CI, 1.3-30.5; P 0.028), higher mortality (52.94% vs.30.51%; OR, 2.9; 95% CI, 1.1-7.8; P 0.038), and a larger infarct volume (106.12±109.78mls vs.73.02±74.36mls.; OR, 1.1; 95% CI, 1.1-1.1; P 0.032), but not with sICH (5.89% vs.5.26%; OR, 1.6; 95% CI, 0.2-12.2; P 0.681). Among women, there was no significant association of anemia with any outcome measures: mRS ≤1 (25% vs.31.25%; OR, 0.84; 95% CI, 0.27-2.59; P 0.754), mortality (25% vs.23.08%; OR, 1.26; 95% CI, 0.4-3.97; P 0.693), infarct volume (60.08±94.46mls vs.69.05±97.74mls.; OR, 1; 95% CI, 1-1.01; P 0.981), and sICH (9.37% vs.5.89%; OR, 1.52; 95% CI, 0.26-8.88; P 0.643). Conclusions: Our study demonstrates a gender difference in outcomes in patients with anemia at presentation who undergo MT. In our cohort, men had an association between anemia and mRS≤1, mortality, and a larger infarct volume, unlike women.