Syncope accounts for approximately 1% to 2% of emergency department visits each year and up to 6% of hospital admissions [1,2]. The causes of syncope are numerous, from common benign disorders to life-threatening processes including transient ischemic attack and even stroke. Although cervicocerebral artery dissection is an uncommon etiology in ischemic stroke, it is the second leading cause in patients younger than 45 years, and most of them predominantly involved the extracranial artery [3-5]. Dissections of intracranial arteries are increasingly being recognized with advanced imaging study; however, isolated basilar artery dissection (IBAD) is rarely reported. Here, we present a case of a 32-year-old man who presented to our emergency department with the chief complaint of syncope and finally diagnosed with acute ischemic stroke resulted from IBAD.