In the case of severe stenosis and occlusion of the aortic arch and adjacent large arteries due to various causes, the pressure in the stenosed distal cerebral artery decreases significantly, causing other adjacent cerebral arteries to reverse flow to supply the lower pressure artery to compensate for its blood supply due to the siphoning effect. A significant decrease in the blood supply to the stolen cerebral artery and clinical signs and symptoms of ischemia in the corresponding cerebral tissue are called cerebral artery reflux syndrome. These include subclavian artery steal syndrome, carotid artery steal syndrome, and vertebrobasilar artery steal syndrome. Surgical treatment, such as endovascular stripping, endovascular stenting, or revascularization, may be considered for those with severe ischemic symptoms. Vasodilators and hypotensive drugs are not appropriate. The clinical diagnosis is based on the significant weakening or disappearance of arterial pulsation in the affected upper limb, low blood pressure of more than 20 mmHg compared with the healthy side, systolic murmur heard in the ipsilateral neck, narrowing or occlusion of blood vessels detected by ultrasonography, and symptoms of inadequate blood supply to the vertebrobasilar artery induced or aggravated by moving the affected limb, etc. The diagnosis can be confirmed by the finding of contrast reversal into the affected vessel by DSA.