OBJECTIVE: Not many reports of subclavian artery occlusion complicated by vertebrobasilar junction aneurysm have been published, and no cases have been treated using a distal radial approach. Our case report highlights the effectiveness of this approach in comparison to previous findings. CASE PRESENTATION: An 82-year-old woman was referred to our hospital because of an enlarged vertebrobasilar junction aneurysm. The DSA and CTA results revealed a left subclavian artery occlusion, meandering of the descending aorta, and an aneurysm of the descending aorta. We performed coil embolization using the right radial and left distal radial artery approaches. Considering that the left subclavian artery occlusion was related to the aneurysm enlargement, we decided to perform left subclavian artery stenting. Left subclavian artery stenting was performed 1 month after coil embolization using the same approach. The patient was discharged on postoperative day 8 without complications. CONCLUSION: Vertebrobasilar junction aneurysm and subclavian artery occlusion were treated via a safe and minimally invasive approach through the right radial and left distal radial artery approaches.