Based on two cases and a review of the recent literature, we would like to draw attention to the fact that a cerebellar infarction, localised to the territory of the PICA, can present with just a single clinical feature-acute rotary vertigo. Cerebellar vascular accidents remain a little known cause of acute vertigo, often masquerading as a peripheral vestibular disturbance. The main differential diagnosis is vestibular neuronitis. The prognosis is usually good, but the risk of a late recurrence or of a further cerebro-vascular episode is difficult to predict. This uncommon aetiology should not be ignored because of the risk of progression towards a sort of pseudo-tumoral infarct, in which the risk of a fatal outcome remains ever present. In most cases, however, sequelae are few or absent.