Abstract： Objective： To observe the clinical effect of gastrodin injection combined with alprostadil for posterior circulation ischemic vertigo. Methods：A total of 78 cases of patients with posterior circulation ischemic vertigo were selected and divided into the study group and the control group according to random number table method，39 cases in each group. Both groups were given routine basic treatment，the control group was additionally treated with alprostadil，and the study group was additionally treated with gastrodin injection based on the treatment of the control group. Both groups were treated for seven days. The clinical effect and the adverse reactions in the two groups were compared. Before and after treatment， peak systolic velocity(Vs)，peak diastolic velocity(Vd)，mean velocity(Vm) and pulsatility index(PI) in vertebral artery and basilar artery in the two groups were detected. Results： The clinical effect in the study group was better than that in the control group，the difference being significant(P＜0.05). After treatment，Vs，Vd and Vm in vertebral artery and basilar artery in the study group were larger than those in the control group(P＜0.05)，and PI in vertebral artery and basilar artery was smaller(P＜ 0.05). The incidence of adverse reactions was 7.69% in the study group and 2.56% in the control group， there being no significance in the difference(P＞0.05). Conclusion：Gastrodin injection combined with alprostadil has good curative effect in treating posterior circulation ischemic vertigo， which can improve blood circulation in vertebral artery and basilar artery of patients with high safety.