Cerebral small vessel disease （CSVD） as a common cerebrovascular disease， is currently considered to be the main cause of vascular cognitive impairment （VCI）， accounting for 50% and 70% of VCI. Currently， four neuroimaging markers （cerebral microbleeds， enlarged perivascular spaces， white matter hyperintensities， and lacunar infarcts） have been widely used in the world to constitute the total CSVD load. These imaging markers have been shown to be associated with cognitive impairment. This article reviews the role of total load of CSVD imaging markers in the mechanism and clinical application of VCI in recent years.