Cerebellar atrophy is a finding observed in imaging studies, often discovered during imaging exams without necessarily presenting corresponding clinical symptoms. The possibility of treating cerebellar atrophy depends primarily on its underlying cause. For instance, cerebellar atrophy caused by genetic disorders, such as spinocerebellar ataxia, which results from genetic mutations, lacks highly effective treatment options. The primary approach in such cases is symptomatic treatment, including administering medications that nourish the nerves. Generally, these diseases progressively worsen. Cerebellar atrophy can also be due to neurodegenerative diseases like multiple system atrophy, which are untreatable. However, cerebellar atrophy caused by long-term alcohol consumption may improve to some extent with abstinence and high doses of vitamin B complex. Additionally, cerebellar atrophy resulting from chronic significant ischemia can be alleviated by addressing the ischemic conditions.