OBJECTIVE: To compare functional outcome of posterior circulation (PC) stroke with middle cerebral artery (MCA) stroke. METHOD: We reviewed retrospectively 2, 226 records of stroke patients admitted to our hospital from June 1992 to October 2001, and selected PC stroke patients as a case with exclusion criteria; the presence of other neurological disease, the history of previous stroke, or multiple brain lesions. Also, we considered MCA stroke patients matched to a case as a control. 28 patients were selected as a case and 24 patients as a control. We compared FIM gains and efficiencies. RESULTS: Self care FIM efficiency (0.56+/-0.45) of PC stroke was higher than that (0.43+/-0.24) of MCA stroke and sphincter FIM efficiency (0.04+/-0.10) of the former was lower than that (0.10+/-0.11) of the latter. But, we couldn't detect any difference in cognitive (0.09+/-0.14 vs. 0.14+/-0.14), motor (1.10+/-0.71 vs. 0.87+/-.51), and total FIM efficiency (1.20+/-0.73 vs. 1.02+/-0.60). CONCLUSION: Our study shows the functional outcome of PC stroke previously reported as controversial or rather poor result is favorable like that of MCA stroke, under active rehabilitation intervention. And so we think that comprehensive rehabilitation management is needed for functional regain even in patients with PC stroke.