A rare case of Wallenberg's syndrome associated with a depressed facture in the posterior cranial fossa is reported. A 37-year-old male was admitted to our hospital because of a consciousness disturbance, immediately after falling from a height. On admission he was found to be in a state of drowsiness. Initial CT scans showed a depressed fracture with disappearance of the fourth ventricle and the cisterns, and his condition gradually deteriorated. Suboccipital decompressive craniectomy was then performed, and his condition improved. Neurological examination on day 5, however, disclosed signs of a typical right Wallenberg's syndrome. The right posterior inferior cerebellar artery (PICA) could not be identified on vertebral angiography. Magnetic resonance imaging (MRI) showed a small infarct in the right dorsolateral medulla. Occlusion of the vertebral artery territory due to a nonpenetrating injury is discussed, and comments are made on the mechanisms involved in our patient, with a selective review of the literature.