〔Abstract〕 Objective To analyze the causes of intracranial hemorrhage after mechanical thrombectomy for acute cerebral infarction with large intracranial artery occlusion. Methods The clinical data of 252 patients with intracranial large artery occlusion acute cerebral infarction admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2015 to January 2021 were retrospectively analyzed. According to the intracranial hemorrhage after treatment, they were divided into bleeding group (38 cases) and non-bleeding group (214 cases). Logistic regression was used to analyze the risk factors of intracranial hemorrhage. Results The proportion of patients with a history of diabetes, Alberta stroke program early CT score (ASPECTS) score < 6, thrombectomy times > 3, and systolic blood pressure > 160 mmHg before treatment in the bleeding group were significantly higher than those in the non-bleeding group (P < 0.05). There was no significant difference in other data between the two groups (P > 0.05). Multivariate logistic regression analysis showed that ASPECTS score < 6, history of diabetes, times of thrombectomy > 3, and systolic blood pressure > 160 mmHg were risk factors for intracranial hemorrhage after mechanical thrombectomy (P < 0.001). Conclusion Low ASPECTS score, history of diabetes, more times of thrombectomy and hypertension are all risk factors for intracranial hemorrhage after mechanical thrombectomy for acute cerebral infarction with intracranial large artery occlusion. Attention should be paid to the above indicators when carrying out mechanical thrombectomy for patients.