Bow hunter's syndrome is due to vertebrobasilar insufficiency caused by 
rotational compression of the vertebral artery. We report a case in which an 
osteophyte compressed the left vertebral artery causing cerebellar stroke. The 
patient underwent successful resection of the osteophyte via anterior surgical 
approach, and his symptoms of headache and dizziness dissipated postoperatively. 
This unique syndrome has been treated with multiple modalities and must remain 
in the clinician's differential as a treatable cause of stroke.