The amount of bleeding after vertebral artery trauma is large and ferocious, and it is easily misdiagnosed as carotid artery injury. In clinical practice, it is rare that the vertebral artery is injured by neck trauma alone. We diagnosed and treated 2 patients with vertebral artery rupture and bleeding. Patient 1, female, 41 years old, suffered from neck trauma for 4 hours. After exploration, left vertebral artery anastomosis + left anterior vertebral vein repair + left internal and external jugular vein ligation were performed. The patient developed dizziness 10 days after Brain MR examination considered left cerebellar hemisphere cerebral infarction, vertebral artery occlusion and stenosis, and dizziness disappeared after 4 months of anticoagulant treatment. Patient 2, female, 28 years old, the right neck was swollen for 10 hours, digital subtraction angiography (DSA) showed a pseudoaneurysm in the initial segment of the vertebral artery, hemostasis was difficult during interventional surgery, and anti-infective treatment was given after temporary neck packing, 4 days after operation, neck exploration + tracheotomy was performed, and 18 days after operation, interventional operation was performed again