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The clinical outcome of stroke differs between sexes, representing the first cause of death in women globally. Studies showing differences in the results of endovascular therapy and thrombectomy according to sex are limited and have not been systematically explored. In fact, those studies have not explored the impact of sex in relation to the speed of accessing reperfusion therapies. Moreover, stroke care differs between community and tertiary hospitals, mainly due to difficult access to health resources. However, sex disparities by type of hospital have not been previously explored. A prospective and multi-center registry was conducted to explore the clinical results according to the sex of patients with anterior circulation ischemic strokes treated with endovascular treatment (approved by the Institutional Review Board of every participating hospital, internal code 0992-N-17). Moreover, we investigated whether stroke women are attended in a similar way than men in those nine hospitals network referring to our comprehensive stroke center, regarding the type of hospital and the presence or not of stroke units (SUs) with specialized stroke physicians in those referring centers. Demographic data and clinical characteristics of stroke were registered. We collected data regarding the presence of previous recombinant tissue plasminogen activator (rtPA) administration. Treatment intervals were measured in each phase of the process (door to brain imaging time, door to needle time, computed tomography [CT] to needle time, door to arterial puncture time, and puncture to recanalization time). Angiographic results were measured by the modified Thrombolysis in Cerebral Infarction (mTICI) scale. Recanalization success was defined as mTICI grade 2b-3. Functional outcomes were evaluated with the modified Rankin Scale (mRS) at 90 days. A total of 492 stroke patients treated using endovascular therapies were included, of which 220 were women. Women were older than men (75±13 years vs. 67±13 years, P=0.001). Three hundred twenty-three patients (65.65%) came from hospitals with SU. The complete clinical characteristics according to sex are shown in Table 1. There was no statistical difference in previous rtPA treatment between the groups (41.1% in women vs. 46% in men, P=0.281). With regard to treatment intervals, there were differences in door to CT time (49.49±110.61 minutes in women vs. 33.13±52.70 minutes in men, P=0.042) and in door to needle time (64.78±45.61 minutes in women vs. 51.76±30.41 minutes in men, P=0.022) in patients with previous rtPA administration. Longer delays in treatment administration, espeSex Differences by Hospital-Level in Performance and Outcomes of Endovascular Treatment for Acute Ischemic Stroke