Cerebellar stroke is a common cause of vascular vestibular syndrome. Although vertigo ascribed to cerebellar stroke is usually associated with other neurological symptoms or signs, it may sometimes mimic acute peripheral vestibulopathy (APV), so called pseudo-APV. The most common site responsible for pseudo-APV is a cerebellar infarction the territory of the medial branch of the posterior inferior cerebellar artery (PICA). Recent studies emphasized that normal head impulse test can differentiate acute medial PICA territory cerebellar infarction from APV. Therefore, physicians who evaluate stroke patients should be trained to perform and interpret the results of the head impulse test. Cerebellar infarction in the territory of the anterior inferior cerebellar artery (AICA) can produce a unique stroke syndrome in that it is typically accompanied unilateral hearing loss, which could easily go unnoticed by the patient. The low frequency of vertigo in superior cerebellar artery distribution may be a useful clinical distinction from PICA or AICA cerebellar infarction in patients with acute vertigo and limb ataxia. For the purpose of prompt diagnosis and adequate treatment, it is imperative to recognize the characteristic patterns of clinical presentation of each cerebellar stroke syndrome. Herein I attempt to review concisely the key features of cerebellar stroke from the viewpoint of neuro-otologic findings.