The clinical data of 5 patients with Opalski syndrome were collected， and the literature was reviewed to summarize the etiology and pathogenesis.

All 5 patients with Opalski syndrome were male， with an average age of （58.00±15.96） years. Among them， 4 patients had a long-term history of alcohol consumption， who presented different degrees of Wallenberg syndrome combined with focal limb paralysis.The magnetic resonance diffusion-weighted imaging（DWI） detection results indicated that there was infarction in the medulla oblongata， but the magnetic resonance angiography（MRA） detection results showed that the responsible vessels were different，which was the vertebral artery dissection in patient 1，posterior inferior cerebellar artery occlusion in patient 2－4， and vertebral artery occludsion in patient 5. All 5 patients had some degrees of improvement in their symptoms after conservative treatment. The symptoms of patient 1 were improved significantly after the neurointerventional therapy.

The incidence of Opalski syndrome in men is higher than that in women， and the responsible vessels and the causes of diseases are different. The clinicians can choose different treatment methods according to the etiology in order to give the most effective treatment to the patients.