Bilateral cerebellar infarction is a special case of cerebral infarction. The cerebellum is mainly supplied by the branches of the vertebrobasilar artery, which are the superior cerebellar artery, the anterior inferior cerebellar artery, and the posterior inferior cerebellar artery. Bilateral cerebellar infarction can occur when lesions of the vertebrobasilar artery involve bilateral branches, resulting in acute occlusion or severe stenosis of the vessel. Bilateral cerebellar infarcts, like other cerebral infarcts, can be treated. Since the cerebellum is located in the posterior cranial fossa and connected to the brainstem, once bilateral cerebellar infarction occurs, cerebral edema easily compresses the brainstem, leading to brain herniation formation and endangering life, treatment needs to strengthen dehydration and reduce cerebral edema. For patients with cerebellar infarction with occupying effect, debulking decompression can effectively prevent brain herniation and brainstem compression and save lives.