Objective To investigate the correlation of vertebral artery dominance（VAD） and basilar artery（ BA） curvature with posterior circulation infarction（ PCI）， and to analyze the relationship between VAD of patients with different infarction of the posterior circulation and BA curvature. Methods According to magnetic resonance angiography（ MRA） and the diagnostic criteria of VAD， a total of 156 patients with PCI， dizziness and headache were selected and divided into VAD group（ n=86） and non-VAD group（ n=70）. The incidence of separate territory infarction in posterior circulation and the incidence of BA curvature were compared between the two groups. The relationship between the laterality of posterior infarction and the laterality of VAD of the infarction area in the VAD group was analyzed．It also discussed the correlation of BA curvature with laterality of VAD and PCI. Results A total of 85.1%（ 40/47） patients had an opposite directional relationship between dominant VA and BA curvature， and the direction of BA curvature and VAD was negatively correlated（ r=-0.704， P＜0.01）. The total incidence of PCI in VAD group was significantly higher than that in non-VAD group［ 51.2% （44/86） vs. 22.9%（ 16/70），χ2=13.063，P＜0.01］. The incidences of infarctions in posterior inferior cerebellar artery（ PICA） territory and BA territory were both statistically higher than that in controls， however， there was no difference in superior cerebellar artery（ SCA） and posterior cerebral artery（ PCA） territory infarction between the two groups. The incidence of PCI in BA curvature patients was significantly higher than that in BA straight patients with statistical difference， and the difference of infarction incidence in residual territories was not significant. Conclusions The incidence of BA curvature is higher in VAD patients， and BA usually bends to the opposite side of dominant VA. The incidence of PCI is higher in VAD patients， especially in PICA infarction and BA infarction patients. Most PICA infarctions occurred on the opposite side of dominant VA and the laterality of BA curvature， while the BA pontine branch territory infarction were on the side of dominant VA， which is the opposite side of BA curvature.