Objective To investigate the features and dynamic changes of cognitive impairment after anterior circulation transient ischemic attack (TIA).Methods A total of 82 patients with anterior circulation TIA who were hospitalized in Department of Neurology, Henan Provincial People's Hospital, from August 2017 to August 2018 were enrolled as TIA group, and all of them underwent cranial perfusion-weighted imaging (PWI). Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive and motor function on day 7 and at 1 month±3 days, 3 months±53 days, and 6 months±7 days after disease onset. A total of 90 individuals who underwent physical examination were enrolled as normal control group.Results At the above four time points after disease onset, there were 46 (60.5%), 48 (63.1.0%), 60 (78.9%), and 65TIA patients (85.5%) with cognitive impairment, respectively. The TIA group had a gradual reduction in total MoCA score from month 1 to month 6 after disease onset (P<0.05), and the TIA group had a significantly lower total MoCA score than the normal control group at each time point (P<0.05). As for the domains of MoCA, the TIA group had significant reductions in the scores of visual space and executive ability, delayed recalls, language repetition, and verbal fluency (P<0.05).Conclusions Cognitive impairment may occur in the early stage of TIAand continue to exist, and cognitive function is significantly reduced at 3 months after the onset of TIA.