Posterior circulation ischemia refers to the transient ischemic attack and the cerebral infarction in vertebrobasilar artery system, its prognosis is not as good as anterior circulation ischemia, and its treatment is similar to that of anterior circulation ischemia. However, because of the mortality of basilar artery occlusion is higher, usually more aggressive treatment should be considered, such as thrombolytic therapy （especially intra-arterial thrombolysis） and endovascular therapy, and the therapeutic time window is much longer. This article reviews the treatment of anterior circulation ischemia.