Migraine with brainstem aura is one of the subtype of migraine with aura, with varied etiology and complex mechanism. Migraine with brainstem aura and transient loss of consciousness (TLOC) often occur together clinically, seriously affect the social life of the patients. At present, relation between migraine with brainstem aura and TLOC has not been elucidated, and clinical manifestations between TLOC and syncope is similar and easily confused by physicians. In order to deeply explore the complex relations between migraine with brainstem aura and TLOC, this article summarizes the clinical association, pathogenesis and differential diagnosis of migraine with brainstem aura associated with TLOC, so as to further optimize the clinical diagnosis strategies and provide new ideas for exploring comprehensive treatment measures for migraine with brainstem aura associated with TLOC.