Vertebrobasilar strokes can yield varied disturbances of eye movements, by affecting specific centers and pathways contained in the brain stem and cerebellum. Unique disorders combining supranuclear, nuclear, and infranuclear syndromes may occur. Some eye-movement abnormalities are useful localizing signs (eg, gaze palsies, rotatory nystagmus, and ipsilateral saccadic bias), but many others are not. The use of techniques such as magnetic resonance imaging may provide new insights in clinicotopographic correlations in patients with good recovery, in the absence of pathologic verification.