Ischemic infarctions in certain vascular territories of the cerebellum and brain stem can produce some characteristic radiologic and clinical patterns. The cerebellum serves as a coordination center for the maintenance of equilibrium and muscle tone and refines the movements of the somatic muscles. The anatomy of the brain stem is extremely complex, and small infarcts can potentially be disastrous. MR imaging depicts the anatomy of the posterior fossa and infarcts in this region with greater accuracy than was previously possible. Familiarity with the vascular territories and patterns of infarction of the posterior fossa depicted with MR imaging and familiarity with the associated clinical symptoms of stroke in this region can help the radiologist recognize these infarcts and correlate clinical and radiologic findings. When patients are referred for MR imaging of the brain because of clinical findings suggestive of infarction, it may be useful to obtain coronal or sagittal views in addition to axial images to better depict the vascular distribution of a suspected ischemic lesion.