Objective To investigate the relationship of cognitive impairment after cerebral infarction with serum level of visinin-like protein-1 (VILIP-1) and neural functional deficiency.Methods One hundred and twenty patients with acute cerebral infarction were enrolled and divided into impaired cognition group and normal cognition group according to their Montreal Cognitive Assessment (MoCA) performance. Serum level of VILIP-1, National Institutes of Health Stroke Scale (NIHSS) score, and Barthel index (BI) score on admission and at 1 year after stroke were compared between the two groups. The relationship of MoCA score with serum level of VILIP-1, NIHSS score, and BI score was analyzed.Results Patients in the two groups had significantly lower NIHSS scores and significantly higher BI scores at 1 year after stroke than on admission (both P<0.01). The impaired cognition group had a significantly higher serum level of VILIP-1, a significantly higher NIHSS score, and a significantly lower BI score than the normal cognition group on admission and 1 year after stroke (all P<0.01). The MoCA score was negatively correlated with the serum VILIP-1 level and the NIHSS score, and positively correlated with the BI score on admission (r=-0.736, P=0.000; r=-0.575, P=0.000; r=0.431, P=0.000) and at 1 year after stroke (r=-0.450, P=0.000; r=-0.377, P=0.001; r=0.483, P=0.000).Conclusions Cognitive impairment after cerebral infarction has important impacts on the serum level of VILIP-1 and neural function recovery.