Abstract： Objective To evaluate the efficacy and safety of stenting on symptomatic severe M1 segment stenosis (>80% lumen reduction) of the middle cerebral artery. Methods Thirty-two patients with symptomatic severe M1 segment stenosis of the middle cerebral artery, admitted to our hospital from July 2007 to August 2010, were included in this study. These patients were diagnosed by cerebral angiography and treated using balloon-expandable stents. Their clinical data were collected; the success rate of the treatment, perioperative management and complicatious, stroke during the follow-up period and reangiostenosis were further discussed. Results The success rate was 93.8% (30/32) for total lesions. During the perioperation, 2 patients had cerebral infarction and one of them was asymptomatic ischemic stroke; no other complications appeared. No recurrence of ischemic stroke or death appeared in these 32 patients during the mean 12.6 months of follow-up. Conclusion Stenting based on drug treatment appears to be an effective and feasible therapy for symptomatic severe M1 segment stenosis of the middle erebral artery, but also appears to have the perioperation complication.