Abstract: Objective To investigate the relationship between vascular cognitive impairment and rt-PA intravenous thrombolysis after cerebral infarction. Methods Forty-six patients with cerebral infarction treated from January 2016 to February 2018 were enrolled. All patients were treated with rt-PA intravenous thrombolysis. The patients were completed with MMSE, NIHSS and MoCA scores after admission. They were divided into cognitive dysfunction group and a cognitive function normal group. The data of the two groups were reviewed. The age, infarction, education level, poor glycemic control, rt-PA intravenous thrombolysis, history of hypertension, alcoholism, left infarction, and single factor and multivariate logistic were recorded. The effective measures for the patient's cognitive function risk factors were analyzed, established and intervened. Results In 46 patients with cerebral infarction, 29(63.04%) had vascular cognitive impairment. The results of single factor analysis showed that the incidence and age of vascular cognitive impairment after cerebral infarction(t=2.244, P=0.030), infarction in key position(χ²=4.313, P=0.038), education level(U=8.092, P=0.003), rt-PA intravenous thrombolysis(χ²=7.558, P=0.006) were statistically significant(all P<0.05). The results of multi factor logistic analysis showed that the incidence of vascular cognitive impairment after cerebral infarction was statistically significant(P<0.05). There were significant differences in the birth rate and age(P=0.042), critical site infarction(P=0.025), education level(P=0.041), rt-PA intravenous thrombolysis(P=0.030). Conclusion The incidence of vascular cognitive impairment after cerebral infarction is high, and there are many influencing factors. Early administration of rt-PA intravenous thrombolytic therapy can improve the cognitive function and reduce the patient's condition.