Objective To investigate the influencing factors of cognitive impairment in patients with lacunar infarction (LI) and to analyze the features of cognitive impairment at different parts in patients with LI.Methods Patients with LI and normal controls were enrolled in the study.Mini-Mental Status Examination (MMSE) was used to evaluate cognitive impairment.California Verbal Learning Test (CVLT),Verbal Fluency Test (VFT),Benton Judgment of Line Orientation Test (BJLOT),Digit Symbol-Coding subtest (DSCT),Paced Auditory Serial Addition Test (PASAT),and Wisconsin Card Sorting Test (WCST)were used to evaluate attention,information processing speed,memory,verbal fluency,and executive function.Results A total of 98 patients with LI and 20 normal controls were enrolled.Of the 98 patients with LI,31 had cognitive impairment and 67 were cognitively normal.The proportions of hypertension,diabetes,multiple LI,and severe white matter lesions,as well as the level of low-density lipoprotein cholesterol in the CI group were significantly higher than those in the normal controls (all P ＜ 0.05).Multivariate logistic regression analysis showed that hypertension (odds ratio [OR] 5.391,95％ confidence interval [CI] 1.515-19.182; P=0.009),diabetes (OR 4.679,95％ CI 1.428-15.339; P=0.011),multiple LI (OR 6.458,95％ CI 1.797-23.213; P =0.004),and severe white matter lesions (OR 6.724,95％ CI 1.440-27.331; P=0.014) were the independent risk factors for the occurrence of cognitive impairment in patients with LI.Among the 98 patients with LI,56 were pure LI (no white matter lesions),but 5 of them were excluded because they could not complete neuropsychological tests.Finally,51 patients were enrolled and were compared and analyzed with the normal control group.Compared to the normal control group,the number of correct answers of WCST-64 in the corona radiata/semi-oval center group (n =15) reduced significantly,and the number of sustained errors increased significantly (P ＜ 0.05).The scores of verbal fluency,DSCT,PASAT,as well as the number of correct answers and the number of completed categories of WCST-64 decreased significantly in the basal ganglia group (n =20) (all P ＜0.05).The scores of short-term memory and delayed recall,as well as the scores of DSCT and PASAT decreased significantly in the thalamus group (n =16) (all P ＜0.05).Conelusiuns Hypertension,diabetes,multiple LI,and severe white matter lesions are the independent risk factors for occurring cognitive impairment in patients with LI.The corona radiata/semi-oval center infarction is easy to complicate with impaired executive function.Basal ganglia infarction is associated with verbal fluency,information processing speed,attention,and executive function impairment.The cognitive impairment of thalamic infarction is mainly manifested in the memory,attention,and information processing speed.