Vertebral artery hypoplasia (VAH) may influence migraines, and may also have some bearing on migrainous vertigo (MV), but the research literature is limited. Two female patients, one 40- and one 36-years-old presented with frequent attacks of vertigo, headache, nausea, vomiting, photophobia and phonophobia for a period of time. The patients also previously suffered from visual disturbances, ataxia, and paresthesia, though they did not suffer from syncope or muscle weakness. Caloric tests were normal, but electronystagmogram and vestibular evoked myogenic potentials were revealed as abnormal. Duplex scanning of neck vessels and magnetic resonance images revealed right VAH instead of other central lesions. Finally, they were cured by anti-migraine therapy, and respectively diagnosed with: 1) MV of basilar-type migraine and 2) MV of migraine without aura, and they both had VAH. The recurrence of MV should then be prevented, but a daily use of anti-platelet was also recommended to lower the risk of posterior circulation ischemia.