Background: Vascular disease contributes from 25 to 50 percent of cases of dementia, and vascular dementia is the second most common type of dementia in clinical and population studies, surpassed only by Alzheimer’s disease. Vascular dementia refers to any dementia caused primarily by cerebrovascular disease or cerebral flow disorder and can be included in the spectrum of vascular cognitive impairment. Vascular dementia is a syndrome, not a disease and can be caused by any stroke or cardiovascular disease that leads to vascular injury or brain dysfunction, including any of the mechanisms of ischemic stroke (e.g., cardiac embolism, large vessel atherosclerosis, small vessel disease), or hemorrhagic stroke. The diagnosis of vascular dementia is not complete until cardiovascular risk factors have been identified, as this information is needed to develop a secondary prevention plan. Similar to vascular dementia, vascular cognitive deficit is a syndrome that can be caused by any cerebrovascular and cardiovascular disease that leads to vascular brain damage or dysfunction. Neuroimaging has greatly improved the ability to detect and diagnose strokes and silent manifestations of cerebrovascular diseases that affect cognition. Treatment includes the management of vascular risk factors, as well as pharmacological and non-pharmacological approaches. Conclusions: The term “vascular cognitive impairment” refers to “cognitive impairment that is caused by / or associated with vascular risk factors”. Better control of vascular risk factors may prevent development or progression of vascular dementia, but no effective treatment is known at this time.