Vertebrobasilar artery insufficiency (VBI) is a common cerebrovascular disease in middle-aged and elderly people. With the aging of the population, the incidence is increasing. In the past, the diagnosis mainly relied on clinical data, but in recent years, with the help of brainstem evoked potential (BAEP), transcranial Doppler Cl℃D), cerebrovascular DSA examination, it is beneficial to the early diagnosis of this disease and determine the lesion site. vBI has many symptoms but few signs, clinical diagnosis is difficult, and there is no uniform diagnostic standard at home and abroad. Vertigo, dizziness, unstable walking, vomiting and tinnitus are common symptoms, especially the incidence of vertigo reaches 88.1%. When accompanied by blurred vision, diplopia, hearing loss, slurred speech, difficulty in swallowing, abnormal sensation of face and limbs, and transient haze of consciousness, the diagnosis is more helpful. The signs are mainly balance disorders, especially unstable walking and inability to walk in a straight line, which disappears when the disease is in remission, thus this sign is not only helpful for diagnosis but also for judging the efficacy. According to the characteristics of the symptoms and the duration of the attack, there are intermittent attacks and slow and continuous attacks. The former is a transient and reversible ischemic neurological impairment of the vertebrobasilar system. The latter occurs more often in elderly patients due to the sclerotic narrowing of the vertebrobasilar artery, so that there is a potential risk of cerebral infarction due to long-term inadequate blood supply. A history of previous stroke indicates that the internal carotid artery system and the vertebral basilar artery system are often coexisting with atherosclerosis, hypertension, hyperlipidemia, especially with significantly elevated triglycerides, and diabetes mellitus, which are the main causes of atherosclerosis. Intracranial atherosclerosis is the main etiology. The pathogenic effect of cervical spondylosis on VBI has been recognized. Due to the change of physiological curvature and position during degeneration, the vertebral artery is stretched and twisted and compressed, and the sympathetic nerve fibers around the vertebral artery are stimulated by bone spurs, causing vasospasm, and all the above factors can make the vertebral artery blood supply insufficient. VBI is not only a common cerebrovascular disease in middle-aged and elderly people, but also in young people. This shows that we should pay attention to the prevention and treatment of cerebral atherosclerosis in young people.