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Background This study evaluated the performance of the newer-generation Emboguard Balloon Guide Catheter (EBGC) in treating anterior circulation large vessel occlusions (LVOs).Methods A prospectively maintained endovascular thrombectomy database was reviewed to identify consecutive non-tandem LVO patients treated with the EBGC. Procedural outcomes included rates of complete recanalization (modified Thrombolysis in Cerebral Infarction (mTICI) 2c/3), successful recanalization (mTICI 2b/3), first-pass effect (FPE) (mTICI 2c/3 after the first pass), modified FPE (mTICI 2b/3 after the first pass), and the number of passes. Clinical outcomes assessed included National Institutes of Health Stroke Scale (NIHSS) scores at discharge, functional independence (modified Rankin Scale (mRS) 0–2), and fair outcomes (mRS 0–3). Safety outcomes evaluated included symptomatic intracranial hemorrhage (sICH) and 90-day mortality.Results Of the 72 patients included, 56.9% (41/72) were female, with a median age of 73 years (IQR 67–83). Most patients presented with middle cerebral artery (MCA) occlusions (M1 in 59.7% (43/72) and dominant/co-dominant M2 in 25.0% (18/72)). Successful recanalization (mTICI 2b/3) was achieved in 98.6% (71/72) of cases, and complete recanalization (mTICI 2c/3) was achieved in 76.4% (55/72), with a median of 1 pass (IQR 1–2). FPE and modified FPE were achieved in 48.6% (35/72) and 56.9% (41/72) of cases, respectively. The median NIHSS improved significantly from 17 (IQR 11–21) at baseline to 4 (IQR 1–12) at discharge. sICH occurred in only 1.4% (1/72) of cases. At 90 days, 42.6% (23/54) of patients achieved functional independence (mRS 0–2), and mRS 0–3 in 63.2% (36/57).Conclusions The EBGC demonstrated promising potential with high rates of FPE and successful recanalization together with clinical improvements and a favorable safety profile.