Abstract: Vascular dementia is a progressive neurocognitive disorder caused by cerebrovascular damage and other factors, and it is the second most common type of dementia after Alzheimer's disease. As the cause of the disease is not yet clear, the current treatment is mainly supportive measures and risk factor control. Numerous studies have shown that microRNA, as an endogenous non-coding RNA, mediates gene silencing by recognizing specific sequences in target messenger RNA, and it is a key factor in the development of vascular dementia. In this article, we review the microRNA intervention in the blood brain barrier, synaptic plasticity, neuroinflammation, neuronal autophagy and apoptosis, with a view to constructing a mechanism network of microRNA regulating vascular dementia, and providing a theoretical basis for the clinical diagnosis and the development of targeted drugs in the future.