The manufacture and dextran-rejection properties of asymmetric poly(vinyl alcohol) (PVA) membranes have been described in this study. Membranes were prepared from a casting solution of PVA, water as solvent, and water-soluble polymeric additive by immersing them in Na2SO4/KOH/H2O as coagulant medium. Experiments showed that the dextran and poly(vinyl pyrrolidone) (PVP) additives exerted a different influence on the structure and permeability of membranes. Especially, the structure of skin layer strongly depended on the polymeric additives in the casting solution. The addition of dextran additives in the system could induce pores in the top layer. Conversely, the PVP additives effectively blocked the interstitial cavities within the top layer to generate a more compact structure. A mechanism describing that the affinity between additive and casting solution as well as between additive and coagulant medium was proposed to investigate the effect of dextran and PVP additives in the formation of PVA membranes. The results presented here offer a better understanding of relationships between the membrane formation mechanism and the skin structure when designing an asymmetric membrane by the addition of polymeric additives in the casting solution.