Objective: To explore the clinical risk factors of leukoaraiosis (LA). Montreal cognitive scale was used to evaluate the characteristics of cognitive dysfunction in LA patients and control group. Methods: 114 patients with LA were selected as the study group and 40 as the normal control group. All the patients in the group should record the basic clinical data in detail, use Fazekas scale to grade the severity of La, and use MOCA to evaluate the cognitive function of the patients in the group. Results: 1. There were no statistically significant differences in age, gender, years of education, smoking and drinking between the study group and the control group (P> 0.05). There were significant differences in hypertension, diabetes, coronary heart disease and hyperlipidemia between the study group and the control group (P< 0.05). Multivariate logistic regression analysis showed that hypertension, diabetes mellitus, coronary heart disease and hyperlipidemia were independent risk factors for LA (P< 0.05). 2. The MoCA scores of all LA patients in all cognitive domains were lower than those of the control group, and the differences in visual space and executive ability, naming, attention, delayed recall, language function, orientation and abstract thinking between LA patients and the control group were statistically significant (P< 0.05). In severe LA group, the scores of all cognitive domains in MoCA scale were visibly decreased (P< 0.05), which indicated that severe LA patients had comprehensive cognitive impairment, especially visual space, executive ability and memory impairment. Conclusion: Hypertension, diabetes mellitus, coronary heart disease and hyperlipidemia are independent risk factors for LA, but LA has no significant relationship with age, gender, years of education, smoking and drinking. Patients with LA may have multiple cognitive impairment at the same time, with the most significant impairment in visual space and executive ability, and delayed recall function.