Abstract：The etiology，pathogenesis and treatment of posterior circulation ischemic vertigo are discussed and analyzed based on the theory of loss of nourishment in sea of marrow. It is concluded that posterior circulation ischemic vertigo belongs to the category of vertigo in Chinese medicine. There is a close relationship between the sea of marrow in Chinese medicine and the circulation system after modern anatomy. Vertigo is caused by kidney essence insufficiency，loss of nourishment in sea of marrow， essential qi deficiency， failure to fill the brain orifices， low- quality essence and failure to perfusion. The clinical syndromes should be closely linked to the pathogenesis of deficiency in sea of marrow； the internal treatment is mainly to tonify the kidney and supplement essence， and nourish the sea of marrow； the external treatment should be bonesetting and sinews-emolliating，with dredging as a supplement，so that the brain orifices are filled，the sea of marrow is nourished，and the vertigo is cured.