Background: Previous studies reported that red cell distribution width (RDW) was related to acute ischemic stroke (AIS). Endovascular treatment (EVT) still faces a huge challenge: futile recanalization. The goal of our study was to investigate the relationship between futile recanalization and RDW in AIS patients receiving EVT. Methods: We retrospectively identified 188 AIS individuals with anterior circulation occlusion throughout EVT and obtained complete or near-total recanalization. The subjects were classified into futile recanalization group by their 3-month modified Rankin scale (mRS) score \ge3. The predictive value of RDW was calculated using receiver operating characteristic (ROC) curves, area under the curve (AUC) values, and logistic regression approaches. Results: One hundred and eleven (59.0%) patients were defined as futile recanalization. The RDW was observed as an novel factor of futile recanalization in the multivariate regression model ([OR, odd-ratio] = 5.233, 95% [CI, confidence interval] = 2.656–10.307; p 0.001). According to the ROC, the model integrating RDW with other risk factors had a relatively higher AUC compared than the RDW alone model (0.944 vs 0.798; p 0.001) via DeLong’s test. Conclusions: Higher RDW is associated with poor functional outcome in anterior circulation AIS patients undergoing EVT at 3 months.