Objective To investigate the risk factors of vascular cognitive impairment with no dementia（ VCIND） in patients with moderate to severe internal carotid artery（ ICA） stenosis， and to provide reference for clinical prevention and treatment of VCIND. Methods A retrospective analysis was made of 56 patients with moderate or severe ICA stenosis admitted from April to December 2017， including 26 with VCIND and 30 without VCIND. The clinical data of the two groups were analyzed by univariate analysis， and the risk factors of VCIND in ICA patients with moderate or severe stenosis were analyzed by Logistic regression. Results Univariate analysis revealed that age， systolic blood pressure， cerebrovascular reserve， homocysteinemia（ Hcy） were relative factors of VCIND in patients with moderate to severe ICA stenosis （P ＜ 0.05）. Logistic regression analysis showed that the patient's impaired cerebrovascular reserve and hyperhomocysteinemia were independent risk factors for VCIND in patients with moderate to severe ICA stenosis （OR=6.333，3.733，P ＜ 0.05）. Conclusions Impaired cerebrovascular reserve and hyperhomocysteinemia were independent risk factors for VCIND in patients with moderate to severe ICA stenosis.