Background <p>Treatment options for intracranial atherosclerotic stenosis (ICAS) are limited, but endovascular intervention has gained increasing attention in recent years.</p> Aim <p>To evaluate the safety and efficacy of the Neuroform EZ stent for treating ICAS in the posterior circulation.</p> Material &amp; methods <p>Patients’ (<i>n</i> = 50) eligibility depended on ICAS with severe stenosis (≥ 70%) in the intracranial segment of the vertebral artery or basilar artery shown by cerebral angiography. General information of the participants were recorded, Adverse events during the perioperative period were observed, including in-stent thrombosis, postoperative hyperperfusion, stroke, and mortality. Before the procedure, neurological deficits (NIHSS score) and neurological recovery (mRS score) were recorded at 12 months postoperatively. The degree of vascular stenosis was evaluated prior to and following the procedure, and in-stent restenosis (ISR) was recorded at 12 months post-operation.</p> Results <p>Fifty-two stents were successfully placed in 50 patients, followed by standardized medication. Angiographic follow-up was completed 12-months postoperatively, and there was only one case of ISR (4.35%) was observed. Postoperative stenosis of responsible vessel was significantly relieved (77.98 ± 7.69 vs. 33.85 ± 9.11), with statistically significant differences (<i>P</i> &lt; 0.01). The extent of neurological deficits and effects on daily living activities at 12 months postoperatively exhibited significant improvements, as evidenced by NIHSS scores (2.40 ± 1.37 vs. 0.82 ± 0.77) and mRS scores ≤ 2 (82.0% vs. 98.0%) (<i>P</i> &lt; 0.01). Cerebral perfusion improved, with no significant perioperative complications.</p> Conclusions <p>The Neuroform EZ stent is a safe and effective treatment approach for ICAS in the posterior circulation.</p>