Abstract: Objective To assess the cognitive function in patients with vestibular migraine (VM) and to explore the value of video nystagmography (VNG) in evaluating cognitive function in VM patients. Methods A total of 60 VM patients who were treated at Qidong People's Hospital from March 2022 to June 2023 were selected. Meanwhile, a normal control (NC) group, consisting of 60 individuals without vertigo, migraine, or other neurological disorders, was included. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used to evaluate the overall cognitive function in both the VM and NC groups. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was employed to comprehensively assess neuropsychological and multidomain cognitive functions. VNG was used to observe the oculomotor characteristics in VM patients. Results Compared with the NC group, group VM patients had a significantly increased incidence of mild cognitive impairment (MCI) and significantly decreased MoCA scores, with statistical differences (P<0.01). Multiple cognitive domains, including immediate memory, visual-spatial extent, language function, attention, delayed memory, processing speed, and executive function, were significantly impaired in the VM group, with statistical differences (P<0.05). Group VM patients showed lower MMSE scores than those in the NC group, without statistical differences (P>0.05). VNG analysis indicated that the incidences of abnormalities in the saccade test, smooth pursuit test, optokinetic test, and positional nystagmus were significantly higher in VM patients than those in the NC group (P<0.05). However, the incidences of spontaneous nystagmus and gaze-evoked test did not differ significantly between the two groups (P>0.05). Conclusions Cognitive function in vestibular migraine patients is notably impaired, particularly in memory, language ability, visual-spatial extent, attention, processing speed, and executive function. VNG analysis suggests that the vestibular system has a significant impact on the cognitive function of VM patients.