Objetive To evaluate the imaging characteristics and clinical manifestations of CT angiography in vertebrobasilar dolichoectasia(VBD). Methods The imaging and clinical data of 30 patients with VBD were retrospectively analyzed. The imaging of CTA was performed according to the morphology of vertebrobasilar CTA, and the incidence of cerebral infarction and vascular stenosis was compared with the control group (30 cases). Results (1) According to the performance of VBD on CTA, it is divided into: S type, U type/L type, spiral type; S type clinical symptoms are the lightest, U type / L type is the second, and spiral type is the heaviest. (2) Among the 30 patients with VBD, 12 patients had posterior circulation cerebral infarction, 8 patients had vascular stenosis, and 5 patients in the control group, 17 patients. There was a statistically significant difference in the incidence of posterior circulation cerebral infarction and vascular stenosis between the two groups (P<0.05). Conclusion CTA can be used to classify VBD, and each type of imaging and clinical performance varies. VBD is closely related to posterior circulation cerebral infarction.