Subcerebellar herniation is an inaccurate term, and in terms of neurosurgical specialization, the exact diagnosis is subcerebellar herniation of the cerebellar tonsils. Surgery does not mean that the patient will be fine, and some patients may have residual symptoms. Inferior cerebellar tonsillar herniation malformation usually refers to a group of malformations of the posterior cranial fossa and the posterior brain tissues, including the herniation of the inferior cerebellar tonsils through the region of the occipital foramen magnum with or without cerebellar agenesis or other related intracranial or extracranial defects, and the compression of the inferiorly herniated tonsils against the medulla oblongata and the posterior group of cerebral nerves, which will lead to a wide range of clinical symptoms. Depending on the patient’s condition, so different surgical options are required, which include posterior cranial fossa decompression, posterior cranial fossa decompression with dural plasty, posterior cranial fossa decompression with partial tonsillectomy, etc. The overall postoperative prognosis is good, but also depends on the degree of neurological deficits congenitally present. Most patients with no or mild neurologic deficits have a favorable prognosis, while others have a poorer prognosis, and some may have residual sequelae. Patients with subcerebellar herniation are advised to visit regular hospitals and seek guidance from specialized doctors.