Cognitive impairment caused by ischemic stroke is becoming more and more concerned.It is crucial to explore its pathophysiological mechanism and related clinical predictive indexes for understanding the occurrence,development and treatment of the disease.This article discusses the pathophysiologic mechanism of cognitive impairment after stroke from the aspects of white matter damage,amyloid abnormal deposition,blood-brain barrier damage,and synaptic plasticity injury,and reviews the risk factors,imaging and biological markers that can be used to predict cognitive impairment after stroke.