Background: stroke is the third leading cause of long-term disability and a major cause of mortality worldwide. Eighty percent of strokes are ischemic. Twenty percent of ischemic events involve tissue supplied by the posterior (Vertebrobasilar) circulation. Aim of the Work:the aim of the study was to assess clinical, risk factors, etiology and vascular lesions of vertebrobasilar occlusive diseases in a sample of Egyptian patients with posterior cerebral circulation ischemia at Al-Hussein Neuro-intervention Unit. Patients and Methods: this study was carried out on patients presented with posterior cerebral circulation ischemia undergoing diagnostic cerebral angiography at the Neuro-interventional Unit in Neurology Department of Al -Hussein University Hospital and Bab-Alshaeria University Hospital. We studied risk factors, vascular lesions, symptoms and signs in patients with vertebrobasilar disease. Results: in the present study, DM was the most frequent risk factor, present in 20 patients (66.67%), followed by hypertension (19 patients [63.33%]), hyperlipidemia (14 patients [46.67%]), smoking (13 patients [43.33%]) and IHD (12 patients [40%]). Conclusion: early detection of stenotic lesions is highly valuable for preventing patients from recurrent TIAs and strokes. Recent improvements in imaging with application the arrival of vertebral artery angioplasty and stenting, however, have opened up new opportunities for intervention in this disease. Digital subtraction angiography is the gold standard method for diagnosis of vertebrobasilardiseasesand the most sensitive for detecting intracranial and extracranial stenotic lesions.