Objective To investigate the characteristics of arterial stenosis in patients with cerebellar watershed infarction. Methods The clinical data, including clinical manifestation, magnetic resonance imaging (MRI), diffusion weighted imaging (DWI) and magnetic resonance angiography (MRA) / computerized tomographic angiography (CTA), of 178 cerebellar infarction cases were collected. According to lesion location on DWI, 178 cases were divided into cerebellar watershed infarction group and non-watershed infarction group. According to location of stenosis in MRA/CTA, vertebrobasilar artery stenosis can be divided into 4 types: intracranial, extracranial, combined, and not detected stenosis. The features of stenosis were compared between cerebellar watershed infarction and non-watershed infarction. Results Among the 128 cases, 42 met the diagnosis of cerebellar watershed infarction. The cerebellar watershed infarction cases had mild clinical features and benign prognosis. However, they had a higher incidence of stenosis (90.5%) than non-watershed infarction cases (74.3%). Intracranial, extracranial, combined, and not detected stenosis represented 14.3%, 52.4%, 23.8%, 9.5% in 42 cerebellar watershed infarction cases, and 33.8%, 16.2%, 24.3%, 25.7% in cerebellar non-watershed infarction. Conclusion Although cerebellar watershed infarction patients had more benign clinical features and prognosis, they had a higher incidence of large diameter arteries stenosis, especially stenosis in extracranial arteries and early endovascular treatment should be administrated.