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Iatrogenic injury of vertebral artery resulting in stroke after central venous line insertion. There are many complications of central venous catheter insertion. Iatrogenic injury of the vertebral artery is a rare complication that can result in severe morbidity and mortality. The case presented describes the complication of an acute ischaemic stroke after cannulation of the vertebral artery. There are various techniques when obtaining central access, however the best practice as described by the evidence based guidelines produced by the American Society of Anesthesiologists utilises real-time ultrasound guidance to minimise adverse events.