Vascular cognitive impairment (VCI) has become the main cause of cognitive impairment in the elderly, and vascular cognitive impairment, no dementia (VCIND) is the initial stage of VCI which can be reversible. In recent years, magnetic resonance spectroscopy (MRS) is more and more widely used in clinical practice and has become a research focus due to its high resolution and noninvasiveness. Current studies have shown that cognitive impairment in patients with VCIND affects almost all major cognitive domains including executive function, visuospatial function, perceptual function, and memory. The combined application of MRS and cognitive scales can improve the accuracy in the clinical diagnosis of VCIND. In patients with VCIND, the decrease in NAA/Cr in the frontal and temporal lobes is definitive, but further study on the thalamus is needed. The research results of Cho on the changes in the brain tissue of patients with VCIND were not consistent. In addition, MRS may play an important role in the differentiation between M-aMCI and VCIND. However, there are still many problems in the study of VCIND and the results are inconsistent; therefore, further research is needed.