Objective To investigate the cognitive function of patients with multiple system atrophy (MSA), the presence or absence of cognitive impairment, and the features of cognitive impairment in two subtypes (MSA-C type and MSA-P type), and to provide a reference for clinical diagnosis.Methods Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) were used to measure the cognitive function of 23 MSA patients (13 with MSA-C type and 10 with MSA-P type) and 25 healthy volunteers.Results Compared with the control group, the MSA group had significantly lower MMSE and MoCA scores and a significantly higher ADAS-cog score (P<0.05). Compared with the control group, the MSA group had significantly lower scores on the subscales of visual space/executive ability, attention, language, abstract thinking, and delayed memory of MoCA (P<0.05), as well as significantly higher scores on the subscales of memory, language, and visual space/executive ability of ADAS-cog (P<0.05). Compared with those with MSA-C type, the patients with MSA-P type had a significantly lower MoCA score, a significantly higher ADAS-cog score, significantly lower scores on the subscales of abstract thinking and delayed memory, and significantly higher scores on the subscales of memory and visual space/executive ability (all P<0.05).Conclusions MSA patients have a certain degree of cognitive impairment, and patients with MSA-P type have more extensive and severer cognitive impairment than those with MSA-C type.