Abstract: Objective To explore the risk factors of cognitive impairment in patients with arteriosclerotic non-disabling ischemic cerebrovascular events (NICE). Methods 84 NICE patients with intra/extracranial artery stenosis or occlusion and 71 normal controls were enrolled. The cognitive function in patient s and normal controls were assessed using MoCA scale . Cerebral perfusion imaging was performed in 84 NICE patients. Results 1. Compared with the normal control group, the NICE patient group had older age , higher rates of smoking, hypertension, diabetes, and hyperglycemia ( P＜0.05); The MoCA score of NICE patients was lower than that of the normal control group ( P＜0.05); 2.Low education level and cerebral hypoperfusion were important factors of cognitive decline in NICE patients ( P＜0.05); 3. The cognitive decline of NICE patients with cerebral hypoperfusion was significantly reduced in visual execution, language and delayed recall. (P＜0.05). Conclusion The NICE Patients with large atherosclerotic arteries were often associated with cognitive decline . Hypoperfusion was an important cause of cognitive decline, and high education level was a protective factor of cognitive function . Visual execution, language and delayed recall might be important manifestations in NICE patients .