Objective To explore the prognostic value of neuroimaging score in patients with acute vertebrobasilar artery occlusion(VBAO)with successful revascularization.Methods A total of 83 patients with acute VBAO who underwent endovascular treatment with successful recanalization,modified thrombolysis for cerebral infarction grade 2b or 3 were retrospectively selected.Based on baseline diffusion weighted imaging(DWI)sequences,posterior circulation infarcts were assessed using the novel posterior circulation score(N-PCS),brainstem score(BSS),and posterior circulation Alberta stroke program early CT score(pc-ASPECTS).A 90 d modified Rankin scale(mRS)score ≤2 points was defined as functional independence.The predictive value of the three scores was assessed by the receiver operating characteristic(ROC)curve analysis.Results The N-PCS[median(interquartile range):2(1-2)vs 4(2-5)]was statistically significant between the functional independent group(50 cases)and the poor group(33 cases)(P＜0.001).Multifactorial logistic regression analysis showed that age[adjusted odds ratio(OR)1.08;95％confidence interval(CI)1.02-1.14;P=0.006],baseline National Institutes of Health Stroke Scale(NIHSS)(adjusted OR 1.12;95％CI 1.03-1.20;P=0.005),and N-PCS(adjusted OR 2.84;95％CI 1.30-6.19;P=0.009)were independent prognostic factors for a favorable prognosis.Conclusion The N-PCS based on DWI can predict the prognosis of acute VBAO patients with successful revascularization.