The Percheron artery (artery of Percheron, AOP) is a rare variant vessel. Its acute occlusion can cause a bilateral symmetrical thalamic stroke; typical symptoms of bilateral paramedian thalamic infarcts due to occlusion of AOP are vertical gaze palsy, memory impairment, confusion, drowsiness, hypersomnolence, or coma. We present the MR imaging findings in two cases with cerebral infarction caused by Percheron artery occlusion. Due to the difficulty in the diagnosis of acute Percheron arterial infarction, early conservative treatment is used. The prognosis of the disease is poor, with few patients completely rehabilitating. Therefore, clinicians must understand the characteristics of the disease, provide early diagnosis and administer timely and effective treatment to reduce the patient's disability rate and fatality rate and therefore improve the quality of life of patients. The patient's prognosis has extraordinary significance.