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Introduction: This research evaluates the budget impact of treating acute ischaemic stroke (AIS) using a combination of mechanical thrombectomy (MT) with stent retrievers (SR) and intravenous tissue‐plasminogen activator (IV‐tPA) in Australia. Methods: This study examined the economic impact over five years for a patient cohort based on the number of patients treated with MT+ IV‐tPA in Australia 2021, versus treatment with IV‐tPA alone. A budget impact (BI) model was developed to project direct medical costs (economic impact) of IV‐tPA+ MT with SR vs. Intravenous tissue‐plasminogen activator alone over a five‐year period (2021–2025 inclusive) from a healthcare perspective. The model is composed of a short‐run decision tree model based on a 3‐month post‐treatment modified Rankin Scale (mRS) from the EXTEND‐IA study and a published long‐run Markov state transition model. Acute, mid‐term and long‐term care costs were projected based on anticipated mRS scores from the EXTEND‐IA trial. Estimated yearly and cumulative budget impact were reported to indicate the economic impact of the two treatment strategies for AIS in the Australian healthcare system. Results: MT+IV‐tPA had a greater budgetary impact than IV‐tPA alone, with annual savings starting at Year 1 and continuing through to Year 5. Cost savings of 21% or approximately $36 million can be achieved over five years for the patient cohort treated in Australia in 2021. Each MT procedure performed delivers approximately $3280 in annual health system savings per patient. Conclusion: Treatment of AIS with a combination of MT+IV‐tPA generates significant savings in the Australian healthcare system compared with IV‐tPA alone. [ABSTRACT FROM AUTHOR]