In order to evaluate the value of vertebral angiography in assessment of hemifacial spasm, we reviewed retrospectively the vertebral angiography of 28 patients (30 cases) with surgically proved hemifacial spasm but normal CT scans of posterior fossa. There were 9 males and 19 females. Angiography revealed vascular focus of hemifacial spasm located at anterior inferior cerebellar artery, posterior inferior cerebellar artery, and vertebral artery in 19, 9, and 2 cases respectively. Right side was involved in 20 cases. All involved vessels were elongated, tortuous, and dilated. In conclusion, vertebral angiography was valuable in evaluating hemifacial spasm of vascular origin in the posterior fossa.