Abstract: Vertebral artery stenosis (VAS) is often caused by atherosclerosis.The clinical diagnosis is more difficult because the symptoms are not typical,and the non-invasive examination is not easy to be detected.The annual stroke incidence is higher in patients with VAS,particularly the symptomatic severe vertebral artery stenosis.About 20% of posterior circulation strokes are caused by VAS.This article reviews the epidemiology,natural history,diagnosis and clinical treatment of VAS.