Vertebrobasilar tortuosity does not require treatment, it is a state in which the blood vessels are in, or related to hypertension, mostly in middle-aged and elderly patients, individual patients without any risk factors for cerebrovascular disease, can also be considered physiologically developmental causes. If it is not combined with lesions such as stenosis, no special treatment is needed. Clinically, it is mostly seen in patients with long-term poor control of hypertension, and the long-term pressure on the vertebrobasilar artery can cause tortuosity. If the tortuosity is accompanied by intravascular plaque formation and vascular stenosis, treatment of the primary disease and prevention of ischemic cerebrovascular disease are required. This is because it is necessary to avoid cerebral infarction due to intravascular plaque detachment and also to prevent the progression of insufficient blood supply due to further aggravation of stenosis. In case of simple tortuosity of the vertebral basilar artery, only clinical observation and periodic review are required.