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Introduction In 2015, pivotal trials demonstrated that endovascular thrombectomy (EVT) in patients who had a large vessel occlusion stroke improves functional outcome. We report 10-year trends and outcomes from our centre, which provides EVT to 2.8 million people in northern New Zealand.Methods We performed an audit of all patients who underwent EVT between 1 March 2015 and 1 March 2025 using the compulsory National Stroke Reperfusion Therapy Registry. Baseline characteristics, treatment variables and 3-month outcomes were analysed. Functional independence was defined as a modified Rankin scale score of 0–2.Results 2184 patients were treated with EVT (48% women; mean age 67.6 years), with the number of treated patients increasing year-on-year. 1404 (63.8%) required interhospital transfer (638 (29.2%) via air ambulance). 1868 (85.5%) had successful reperfusion (Thrombolysis in Cerebral Infarction 2b–3). 1015 (46.5%) received intravenous thrombolysis. At day 90, 1095 (51.9%) patients were functionally independent, 1506 (72.8%) were living at home and 327 (15.5%) had died.Conclusion EVT outcomes in New Zealand align with international results despite supra-regional logistical challenges. The growing number of treated cases reflects improved access to EVT across different regions and an expansion of eligibility criteria. Our study supports the continued development and provision of large hub-and-spoke EVT services.