To evaluate the usefulness of three-dimensional (3D) MR black-blood sequence flow-dephasing-prepared fast spoiled gradient recalled echo (FDP-FSPGR) in screening the basilar artery (BA) wall and the ostia of the adjacent branch arteries. Twenty-one patients with BA stenosis >50% on digital subtraction angiography (DSA) were imaged. Three-dimensional FDP-FSPGR images were acquired using a flow-dephasing-prepared segmented technique, including two spin echoes to overcome the inhomogeneity of the radiofrequency field. Precontrast and postcontrast 3D FDP-FSPGR sequences were performed. The wall of the BA could be visualized in 20 patients with good contrast, and 82 ostia of the adjacent branch arteries were identified on 3D FDP-FSPGR images. Compared with DSA, the accuracy of it was 0.94 (95% confidence interval [CI], 0.89 to 0.99) for reader 1 and 0.92 (95% CI, 0.86 to 0.98) for reader 2, with strong agreement between the two readers (κ = 0.82). BA plaque enhancement was noted in 16 of the 20 patients after contrast administration. The 3D FDP-FSPGR can be used for high-spatial-resolution demonstration and large coverage of the BA wall and the ostia of the adjacent branch arteries. This sequence will make it possible to evaluate therapeutic effects in clinical studies.