Abstract：Objective：To observe the clinical effect of Yangxue Qingnao Pills combined with Betahistine for vertigo due to posterior circulation ischemia and its effect on hemorheology indexes. Methods：A total of 118 cases of patients with vertigo due to posterior circulation ischemia were divided into the control group and the observation group according to the random number table method，with 59 cases in each group. The control group was treated with Betahistine Mesilate Tablets， and the observation group was additionally given oral administration of Yangxue Qingnao Pills based on the treatment of the control group. Both groups were treated for 2 weeks. The levels of hemorheology indexes including plasma viscosity (PV)，whole blood viscosity (WBV) and fibrinogen (FIB)，the blood flow velocity of vertebral artery (VA) and basilar artery (BA)， the traditional Chinese medicine syndrome scores， the clinical effects and the incidence of adverse reactions were compared between the two groups. Results： The total effective rate was 91.52% in the observation group， significantly higher than that of 72.88% in the control group， the difference being significant (P＜0.05). After treatment，the levels of PV，WBV and Fib in the two groups were decreased when compared with those before treatment (P＜0.05)， and the levels of PV， WBV and Fib in the observation group were lower than those in the control group (P＜0.05). After treatment， the blood flow velocity of VA and BA in the two groups was increased when compared with that before treatment (P＜ 0.05)，and the blood flow velocity of VA and BA in the observation group was higher than that in the control group (P＜0.05). After treatment， the syndrome scores including dizziness and dizzy vision， nausea and vomiting，fatigue and hypodynamia，tinnitus and deafness，and heaviness of head in the two groups were decreased when compared with those before treatment (P＜0.05)， and the syndrome scores in the observation group were lower than those in the control group (P＜0.05). The rate of adverse reactions was 6.78% in the observation group and 11.87% in the control group， there being no significance in the difference (P＞0.05). Conclusion： Yangxue Qingnao Pills combined with Betahistine has a significant curative effect in treating vertigo due to posterior circulation ischemia，which can significantly improve the hemorheology， blood flow velocity of vertebral arteries and clinical symptoms， with fewer adverse reactions.