An enhanced flexibility neurovascular catheter is provided, such as for distal neurovascular access or aspiration. The catheter includes an elongate flexible body, having a proximal end, a distal end and a side wall defining a central lumen. A distal zone of the side wall includes an outer jacket surrounding a helical coil, and the outer jacket is formed from a plurality of tubular segments positioned coaxially about the coil. A proximal one of the tubular segments has a durometer of at least about 60D, and a distal one of the tubular segments has a durometer of no more than about 35D. An axially extending filament within the side wall extends at least about the most distal 10 cm of the length of the catheter. The axially extending filament serves as a tension support and resists elongation of the catheter wall under tension, such as when the catheter is being proximally retracted through tortuous vasculature.