According to literature data, the prevalence of stroke in the posterior circulation represents 20 30% of all ischemic strokes. It represents a clinical syndrome associated with ischemia in the cerebral territory vascularized by the vertebrobasilar system. The most common etiologies include intrinsic atherosclerosis, cardio embolism, vertebrobasilar dolichoectasia and spontaneous or posttraumatic cervical artery dissection, subclavian steal syndrome, giant cell arteritis, Fabry disease.The purpose of the research the evaluation and analysis of clinical-demographic characteristics in patients with stroke in the posterior circulation within an institutional cohort. Materials and methods: A retrospective cohort study was performed. The medical records of patients hospitalized with the diagnosis of ischemic stroke (codes I64, I633) from the electronic institutional data register of the Institute of Neurology and Neurosurgery from October 2017 to February 2022 were analyzed and 367 patients were selected. Results: Average age 66.8±10.6 years, men - 62%, women - 38%, average duration of hospitalization 10.3±5.0 bed days. Of all the patients included in the study, 71.4% were diagnosed with primary stroke and 28.6% recurrent. The identified risk factors were arterial hypertension - 96.4%, DM - 35.4%, heart rhythm disorders - 34.1%, coronary ischemic disease - 27.8%, atherosclerosis of the major vessels - 59.9%, dyslipidemia - 27.2%, obesity - 18.5%, anamnestic cerebrovascular events 24.5%, smoking 6.5%. Comorbidities were infection 10.6%, cancer 3.3%, rheumatism 1.6%. Doppler of the extracranial and intracranial vessels detected stenotic atherosclerosis of the main vessels 60.5%, occlusion 4.4%, hypoplasia of the vertebral artery 13.1%. Brain imaging: ischemia 77.4%, leukoaraiosis 55%, atheromatous plaques at the level of carotid siphons 34.6%, cerebral atrophy 19.9%, old stroke 17.4% cases. Conclusions: This study describes the spectrum of risk factors, clinical and demographic characteristics of patients with ischemic stroke in the posterior circulation drawn from the institutional cohort.