(en) Multivessel occlusion (MVO) is not uncommon in patients with acute ischemic stroke (AIS) and arises most com-monly from thromboembolic sources such as atrial fibrilla-tion (AF). Acute bilateral middle cerebral artery (MCA) M1 segment occlusion is, however, rare, but raises significant issues for stroke neurologists and interventional radiologists regarding which lesion should be treated first. We describe a case of acute bilateral MCA M1 segment occlusion success-fully treated with bilateral thrombectomy.