Objective To investigate the related factors for long-term cognitive impairment in young patients with cerebral infarction.Methods A total of 58 young patients with cerebral infarction who visited our hospital from January 2008 to June 2013 were enrolled, and according to the long-term Montreal Cognitive Assessment (MoCA) score, they were divided into normal cognitive function group and cognitive impairment group. The demographic data, case data, and activity function were compared between the two groups to screen out the risk factors for long-term cognitive impairment in young patients with cerebral infarction.Results A total of 42 patients completed the follow-up. The mean follow-up time was 5.5 years (range 3.3-7.1 years), and the overall MoCA score was 27.4±3.7. There were 18 patients in the normal cognitive function group and 24 in the cognitive impairment group, and there were no significant differences in sex, educational background, TOAST type, concomitant diseases and hobbies, and application of thrombolytic therapy between the two groups (P>0.05). Compared with the normal cognitive function group, the cognitive impairment group had significantly higher age of onset, National Institutes of Health Stroke Scale (NIHSS) score, and proportions of patients with left anterior circulation infarction, a modified Rankin Scale score of >2 at discharge, and a Instrumental Activities of Daily Living (IADL) score of <8 on reexamination (P<0.05). The multivariate logistic regression analysis showed that NIHSS score on admission, left anterior circulation infarction, mRS>2 at discharge, and IADL <8 at reexamination were independent risk factors for cognitive impairment (OR=1.039, 4.329, 5.143, 12.800, and 21.333, P<0.05).Conclusions NIHSS score on admission, left anterior circulation infarction, mRS>2 at discharge, and IADL <8 at reexamination are risk factors for cognitive impairment in young patients with cerebral infarction. Cognitive function is negatively correlated with NIHSS on admission.