Objective In order to provide a basis for the prevention and treatment of stroke,this study was based on the analysis of vertebral artery lesions in patients with acute posterior circulation infarction based on cervical vascular ultrasound.Methods A retrospective analysis was performed for 765 patients with acute poste-rior circulation infarction in the Department of Neurology,Baotou Central Hospital,who were divided into 270 cases(35.3%)in the young and middle-aged group(aged≤60 years)and 495 cases(64.7%)in the elderly group(≥60 years old).Results The vertebral artery extracranial lesions were the main lesions in the elderly group,and the vertebral artery intracranial lesions and rare lesions(dissection and thrombosis)were the main le-sions in the young and middle-aged patients(P were 0.02 and 0.01,respectively),and there was no signifi-cant difference between the two groups in the patients with normal hemodynamics and vertebral artery physio-logical lesions(P were 0.897 and 0.141,respectively),hypertension(73.6%,563/765)and hyperhomo-cysteinemia(49.7%,380/765)were the most important risk factors between the two groups,and there was no significant difference in the distribution between the hypertension and diabetes groups(P were 0.066 and 0.068,respectively),and there were significant differences in the distribution between the hyperlipidemia and hyperhomocysteinemia groups(both P<0.05).Conclusions There are differences in the distribution of verte-bral artery lesions in patients with acute posterior circulation infarction in different age groups.