Objective To analyze the association between white matter hyperintensities （WMH） and neuropsychiatric symptoms （NPSs） in Alzheimer disease （AD） patients. Methods From April 2021 to March 2022， 97 AD patients who visited the Memory Clinic of the Fourth People's Hospital of Chengdu were selected as the research subject. The cognitive function， ability of daily living， and NPS of patients were evaluated using the Mini Mental State Examination （MMSE）， Activity of Daily Living Scale （ADL）， and Neuropsychiatric Inventory （NPI）. This study conducted the 3T MRI scan of the patient's head， and using UBO-Detector software to extract WMH volume of each brain region of the patients. Partial correlation was used to analyze the association between WMH volume in various brain regions and MMSE， ADL， and NPI scores of AD patients. Results The MMSE， ADL， and NPI scores of 97 AD patients were 11.0 （5.5， 19.0）， 38.0 （26.0， 54.0）， and 16.0 （3.0， 34.0）， respectively. The MMSE score of AD patients was negatively correlated with WMH volume in the whole brain， periventricular， left temporal lobe， and right temporal lobe （r=-0.240，-0.239，-0.332，-0.208； P＜ 0.05）. The ADL score was positively correlated with the volume of WMH in the left and right temporal lobes （r=0.352， 0.257； P＜ 0.05）. The NPI score was positively correlated with the left temporal lobe WMH volume （r=0.373， P＜ 0.05）. Among the 12 symptoms of NPI， delusions in AD patients were positively correlated with left occipital WMH volume （r=0.214， P＜ 0.05）. Hallucinations， agitation/aggression were positively correlated with left temporal and parietal lobe WMH volume （r=0.354，0.212，0.460，0.254； P＜ 0.05）. Anxiety， elation/ euphoria， sleep/nighttime behavior， appetite/eating disorders were positively correlated with left temporal lobe WMH volume （r=0.222， 0.422，0.295，0.222； P ＜ 0.05）. The above differences were statistically significant. Conclusions The degree of white matter damage in the brain is correlated with cognitive function， ability of daily living， and NPSs in AD patients. White matter damage in different brain regions is associated with different NPSs， and preventing white matter damage may improve NPSs in AD patients.