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Objective Case report of acute‐onset oculomotor paresis attributed to thrombotic occlusion of the perforator‐bearing P1 segment of the posterior cerebral artery with preserved perfusion of the basilar tip and P2 segment in the presence of a posterior communicating artery successfully treated by mechanical thrombectomy. Conclusions Short‐segment thromboembolic P1 occlusion can present as acute‐onset oculomotor paresis, so acute diplopia is an appropriate indication for performing a computed tomography or magnetic resonance imaging angiogram as mechanical thrombectomy appears to be an effective therapeutic option.