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In the four included studies, there were 642 frail patients and 499 not frail patients. Frail patients had higher NIHSS on admission [16.3(2.5) versus 15.7(0.6), t=5.16, p<0.01] and were more likely to present with anterior circulation occlusions [97% versus 88%, X 2 =42, p<0.01] compared to their non-frail counterparts. Frail patients experienced reduced rates of successful recanalization [72% versus 80%; X 2 =4.6, p=0.03], reduced rates of good functional outcomes [29% versus 42%; X 2 =22, p<0.01], and increased 90-day mortality [51% versus 25%; X 2 =38, p<0.01] compared to non-frail patients. Conclusion MT for treatment of AIS in frail patients is associated with worse rates of morbidity and mortality along with reduced efficacy. More studies are needed to further evaluate and identify characteristics that may be more favorable to endovascular management in these patients.