Abstract: Objective To investigate the risk factors of clinical symptoms of vertebrobasilar dolichoectasia（VBD）in order to intervene early and reduce the complications of stroke.Methods The clinical data of 184 patients with VBD from 2010 to 2018 were collected and divided into symptomatic VBD group and non-symptomatic VBD group according to whether there were symptoms.The differences of clinical,imaging and hematological examination results between the two groups were analyzed.Results There were 143 cases（77.7%） in symptomatic VBD group and 41 cases（22.3%）in non-symptomatic VBD group.There were significant differences between symptomatic VBD group and non-symptomatic VBD group in the diameters of basilar artery（BA）,the diameter difference of bilateral vertebral artery（VA）,neutrophil to lymphocyte ratio（NLR）,platelet to lymphocyte ratio（PLR）,levels of C-reactive protein（CRP） and homocysteine（HCY）,with or without hypertension,vertebral artery dominance（VAD）,migration,and T2 fluid-attenuated inversion-recovery（FLAIR） vascular hyperintensity（FVH）（P＜0.05）.Logistic regression analysis showed that the presence of VAD and FVH had an effect on symptomatic VBD.Conclusions Patients with symptomatic VBD are more likely to be complicated with hypertension and hyperhomocysteinemia.The related inflammatory indexes NLR,PLR and CRP are significantly higher than those of non-symptomatic VBD patients.VAD and FVH are risk factors for symptomatic VBD.