Posterior fossa houses very vital and sensitive structures namely midbrain, pons, medulla, and cerebellum. These structures are irrigated by vertebral, posterior inferior cerebellar, anterior inferior cerebellar, and superior cerebellar arteries. Parts of brain located in posterior fossa control important parts of body so any variation pertaining to stenosis, atresia, hypoplasia, fenestration, agenesis, and duplication in the arteries supplying these parts alter the irrigation pattern culminating into various morbid and mortal neurologic disorders. Therefore, a sound understanding and thorough knowledge of posterior circulation vascular variant anatomy builds the foundation for the accurate diagnosis and appropriate management of neurovascular ischemic and hemorrhagic diseases of posterior fossa. To aid in addressing these complex neurologic disorders and neurosurgical treatment to be carried out successfully, updating and consolidating the knowledge of all the variations/insults of these arteries becomes essential. Therefore, review study has been carried out.Literature search was carried out using databases, including Scielo, Scopmed, Medline, PubMed, and Wiley online library. Papers containing original data were selected and secondary references retrieved from bibliographies. Search terms used were posterior fossa, anomalies of vertebral, posterior inferior cerebellar, anterior inferior cerebellar, and superior cerebellar arteries.The study will be of paramount importance to angiographers in interpreting angiographs, neurologists in diagnosis and treatment of neurologic disorders, and neurosurgeons in performing surgery in posterior fossa and craniovertebral region particularly dealing with tumors and vascular malformations.