The authors report two cases of cerebellar infarction due to vertebral artery (VA) occlusion resulting from cervical spine trauma. In one patient with dens and C2 body fracture, the left VA was occluded, resulting in a left cerebellar infarction. The second patient, with a subluxation of C4 on C5, presented with cerebellar swelling and infarction along with acute hydrocephalus secondary to bilateral vertebral artery occlusion. Because vertebral artery injuries with cervical trauma are rarely symptomatic, they can be easily overlooked. Bilateral or dominant vertebral artery occlusion, however, may cause rapid and fatal ischemic damage to the cerebellum and brain stem. Rapid recognition and optimal treatment for this injury depends on early vertebral artery angiography.