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Introduction Intracranial arterial stenosis remains a significant cause of ischemic stroke worldwide, with elective treatment options under ongoing evaluation for safety and efficacy. While medical management remains first-line, selected patients with prior TIA or stroke may benefit from interventional strategies.Aim of Study To evaluate outcomes, procedural safety, and clinical characteristics of patients undergoing elective treatment for intracranial stenosis at our center over one-year period.Method A retrospective review was conducted of all patients treated electively for intracranial stenosis at our institution between April 2022 and April 2024. Data included demographics, clinical presentation, imaging, procedural details, perioperative complications, and follow-up outcomes. Treatments involved stent placement, with all patients on standardized dual antiplatelet therapy.Abstract A117 Figure 1Results A total of 13 patients underwent elective procedures. The most commonly affected vessel was the basilar artery (61.5%), followed by the middle cerebral artery (38.5%). Technical success was achieved in all cases. The periprocedural complication rate was 7.7%, with no lasting neurological deficits. No strokes or deaths occurred within 30 days. The 1-year stroke or TIA rate was 7.7%, with no procedure-related mortality. One patient developed restenosis without neurological symptoms.Abstract A117 Figure 2Conclusion Our 1-year stroke rates compare favorably with stenting and medical arms of major trials. The SAMMPRIS medical arm showed 5.8% at 30 days and 12.2% at 1 year; VISSIT reported 9.4% and 15.1%. Our outcomes align more closely with the WEAVE trial, which showed a 2.6% 30-day stroke rate with strict selection. These findings suggest elective intervention may offer comparable safety and durability in selected patients, warranting further validation.Conflict of Interest No