Objective To investigate the influence of vertebral artery (VA) dominance in basilar artery (BA) curvature and pontine or cerebellar infarction occurring around the vertebrobasilar junction.Methods Radiological data (infarction laterality,VA dominance,BA curvature and their directional relationships)were analyzed in 86 patients with acute unilateral pontine or posterior inferior cerebellar artery (PICA) territory infarction.Multiple Logistic regression analysis was performed to predict the moderate to severe BA curvature.Results The dominant VA frequently happened on the left side (69.8％,60/86).The BA curvature frequently happened to be right lateral flexion (74.4％,64/86).In 86 patients,71 patients had negative direction relationship between VA dominance and BA curvature.The diameter grade of VA had significant relationship with hypertension,moderate and severe BA curvature and right diameter of VA (P ＜ 0.05 or ＜ 0.01).The diameter of VA was the only independent predictor for moderate and severe BA curvature (OR =2.81,95％ CI:1.33-6.09).Conclusions VA dominance is an important predictive factor of BA curvature,and BA curvature is usually opposite to the side of VA dominance.VA dominance and BA curvature caused by VA dominance increase the incidence of vertebrobasilar junctional infarction.