Cerebral venous thrombosis (CVT) is an infrequent, but increasingly recognized cause of stroke. It occurs in the setting of dehydration and hypercoagulable states and disproportionately affects women. Clinical presentations range from isolated headache to focal deficits and coma. While first-line therapy has traditionally focused on hydration and anticoagulation, endovascular treatment is increasingly effective and safe. The initial endovascular approaches focused on the infusion of thrombolytic agents, but they have expanded to include mechanical disruption with a variety of devices, including the “stent-retriever” family. Suction thrombectomy has returned to favor with the advent of large inner diameter, highly navigable catheters.