Spinal artery blockage or stenosis brought on by repeated head motions characterizes a bow hunter's stroke. Hypoplastic, stenotic, or blocked contralateral vertebral arteries and minimal input from the anterior circulation via the circle of Willis typically characterize the isolating conditions that lead to the limited blood flow. Vertebrobasilar insufficiency can cause a wide variety of symptoms, from mild vertigo and nystagmus to severe hemiparesis, sensory abnormalities, Horner's syndrome, difficulty swallowing, and even loss of consciousness. When blood flow is briefly blocked, symptoms may be short-lived, but when an embolus or thrombus causes an infarction in the afflicted vascular region, they can last much longer. When the head is rotated while the artery is anchored by surrounding bony or fibrous elements, occlusion of the extra-cranial vertebral artery occurs. Angiography is the gold standard, but other dynamic investigations measuring absolute or relative changes in cerebral blood flow due to head movement are also necessary for diagnosis. Surgery to restrict head rotation or decompress and release the compressed vertebral artery is one of many possible treatments. This syndrome carries a high chance of a cerebrovascular accident with long-lasting consequences, so it's important to take action to reduce that risk. When deciding between surgical procedures, it is important to take into account both the patient's current health and their goals.