Objective To observed hemodynamic changes in the posterior circulation infarction patients with vertebral artery dominance（ VAD）. Methods According to magnetic resonance angiography （MRA） and the diagnostic criteria of VAD， 156 patients with posterior circulation infarction（ PCI）， dizziness and headache were divided into VAD group（ n=86） and non-VAD group（ n=70）. All enrolled subjects were performed transcranial Doppler ultrasound（ TCD） examination. Results The values of systolic velocity（ Vs）， mean velocity （Vm） and diastolic velocity（ Vd） in the dominant VA of VAD group were higher than those in the non-dominant VA of VAD group and bilateral VA of non-VAD group（ P＜0.05）. Compared with bosic artery of two groups，the level of Vd and Vm in the VAD group were less than those in the non-VAD group（ P＜0.05）， and the level of pulsatility index（ PI） and resistance index（ RI） were higher than those in the non-VAD group（ P＜0.05）. There were no significant difference in Vs、Vd、Vm、PI and RI of posterior cerebral artery（ PCA） in two groups（ P＞ 0.05）. Conclusions There are cerebral hemodynamic changes in VAD patients. The blood flow velocity of the dominant VA is faster than that of non-dominant VA， which may be due to posterior circulation infarction.