Introduction. Improving of quality of life of patients with brain ischemic damage due to cerebrovascular disorders in vertebrobasilar basin (VBB) largely based on the adequate use of surgical methods for vertebral artery (VA) stenosis treatment.Materials and methods. Results of surgical treatment of 54 patients with cerebrovascular disorders in VBB caused by VA extravasal narrowing were analyzed. All surgical interventions were reconstructive, de-occlusive, performed using microsurgery equipment. After the surgery the patients were under observation for 3 years.Results. Surgery for VA stenotic lesion was performed according to created criteria allows to achieve positive hemodynamic effect accompanied by signs of clinical improvement that was established according to the examination of more than 95% of operated patients, at whom conservative treatment does not alter the disease course. Surgery on VA magistral parts has some bordering contraindications (usually general surgical) and can be performed even in servere ill patients.Conclusions. Reconstructive surgery at VA stenosis is the most appropriate method for treatment of most patients with cerebrovascular insufficiency in VBB, caused by VA stenosis. Expanding indications for reconstructive will improve conditions for further rehabilitation of patients with cerebrovascular insufficiency in VBB.