Vertebrobasilar Dolichoectasia (VBD) is a condition characterized by abnormal elongation, dilatation and tortuosity of the vertebrobasilar system. It is usually asymptomatic but rarely, it can present with cranial nerve compression symptoms. We present a case of simultaneous trigeminal neuralgia and hypoglossal nerve palsy due to compression by VBD. Neuroimaging plays an important role in diagnosing this condition so that further treatment can be provided.