Cervical artery dissection is a major cause of stroke in young adults. Although the pathophysiology is unclear, it is thought to be a multifactorial disease, with an interaction between environmental and genetic factors. Its clinical signs and symptoms may be vague and the diagnosis may be delayed. In this context, we report a case of vertebral artery dissection and ischemic stroke in a 22‑year‑old woman, as a result of a combination of anatomical and environmental risk factors. The detailed anamnesis, the clinical examination, the neurological examination, the imaging investigations allowed to establish the correct diagnosis, the appropriate treatment and the measures of secondary prevention of the stroke. This case highlights the importance of a detailed medical history to identify risk factors and potential rare causes of stroke, especially in young adults. Also, that the role of environmental factors should not be underestimated.