Objective To employ three dimensional high-resolution vessel wall magnetic resonance imaging (3D hr-VW-MRI) for analyzing the imaging characteristics of posterior circulation non-stenotic intracranial atherosclerotic plaque and to discuss its diagnostic value in identifying culprit plaques. Methods Ninety-three patients (age ［62.94±9.70］ years old, 67 males, 26 females) with non-stenotic atherosclerosis in our hospital from Jan. 2019 to Jan. 2021 were retrospectively recruited. The imaging features of plaques, including luminal area, maximum wall thickness and minimum wall thickness at the most stenotic site, stenosis rate, plaque burden, remodeling index, eccentricity index, enhancement ratio at the most stenotic site, and intraplaque hemorrhage, were measured based on T1-weighted imaging (T1WI) and contrast-enhanced T1WI. The culprit plaque was defined as a lesion arising from the responsible vascular supply area to a fresh infarction on the diffusion weighted imaging (DWI) and T2 fluid attenuated inversion recovery (T2-FLAIR) images with accompanying ischemic stroke/transient ischemic attack (TIA). A plaque was considered to be a nonculprit plaque when it occurred in patients with presumed ischemic stroke/TIA, but without an infarct on DWI and T2-FLAIR. Results Sixty-one culprit plaques and 32 non-culprit plaques were analyzed. The proportions of patients with hyperlipidemia, National Institutes of Health stroke scale (NIHSS) score, narrowest plaque enhancement rate, and incidence of intraplaque hemorrhage in the culprit plaque group were significantly higher than those in the non-culprit plaque group (all P＜0.05). Multivariate logistic regression analyses showed that NIHSS score (odds ratio ［OR］ ＝1.799, 95% confidence interval ［CI］ 1.303-2.484, P＜0.001), enhancement ratio (OR＝1.076, 95% CI 1.027-1.128, P＝0.002) and intraplaque hemorrhage (OR＝30.708, 95% CI 2.563-367.925, P＝0.007) were associated with plaque type. Conclusion NIHSS score, enhancement ratio at the most stenotic site, and intraplaque hemorrhage are independent risk factors for culprit plaques in patients with posterior circulation non-stenotic intracranial atherosclerotic disease. These indicators may help identify such culprit plaques and could be used to screen individuals with plaques having these characteristics, thereby providing a basis for early preventive interventions.