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Isolated basilar artery stenosis (BAS) is a rare etiology of ischemic neurologic conditions. First-line treatment of symptomatic stenosis is typically medical therapy as outlined in the Warfarin–Aspirin Symptomatic Intracranial Disease (WASID) trial and the Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis (SAMMPRIS) trial.1,2 We present the case of a male in his 60s with isolated BAS who failed maximal medical treatment but experienced a decrease in transient ischemic attacks and acute ischemic stroke occurrences after angioplasty and stenting.