Objective To study the relationship between cognitive impairment and neurological function recovery in patients with cerebral infarction, so as to provide an effective reference for the clinical treatment of cerebral infarction. Methods The clinical data of 179 cases patients with cerebral infarction admitted to Guangzhou Eighth People’s Hospital, Guangzhou Medical University from October 2017 to October 2020 were retrospectively analyzed, according to the montreal cognitive assessment scale (MoCA) score at admission, all patients were divided into the cognitive normal group (MoCA score≥?26 points, 111 cases) and the cognitive impairment group (MoCA score<26 points, 68 cases), after treatment, patients in both groups were followed up for 6 months. The national institutes of health stroke scale (NIHSS) , barthel index (BI) and MoCA scores of patients were compared between the two groups at admission and 3, 6 months after followed up; the general data of patients in the two groups were analyzed by single factor analysis, and the factors with statistical significance were analyzed by multivariate Logistic regression analysis, so as to screen the independent risk factors of cognitive impairment after cerebral infarction; the relationship between cognitive impairment and neurological function recovery in patients with cerebral infarction was analyzed. Results Compared with admission, the NIHSS scores of patients in the two groups 3 and 6 months after followed up decreased significantly, and the NIHSS scores in the cognitive normal group were significantly lower than those in the cognitive impairment group at different time points; while the BI and MoCA scores increased significantly, and which in the cognitive normal group were significantly higher than those in the cognitive impairment group at different time points; the proportion of patients with osteoporosis, the score of social support rating scale (SSRS) scores of patients in cognitive impairment group were significantly higher than those in the cognitive normal group, while the level of serum homocysteine(Hcy) of patients in the cognitive impairment group was significantly lower than that in the cognitive normal group; the results of multivariate Logistic regression analysis showed that, NIHSS score increasing, BI score decreasing, MoCA score decreasing, combined with osteoporosis, serum Hcy level increasing, and SSRS score decreasing were all the risk factors of cognitive impairment after cerebral infarction (OR=2.045、1.578、2.144、 1.893、2.245、1.936, all P<0.05); Pearson relationship analyze showed that, MoCA score was negatively correlated with NIHSS score in patients with cerebral infarction (r =-0.365, P<0.05), MoCA score was positively correlated with BI score (r =0.514, P<0.05). Conclusion Patients with cerebral infarction are prone to cognitive dysfunction, NIHSS score increasing, BI score decreasing, MoCA score decreasing, combined with osteoporosis, serum Hcy level increasing, and SSRS score decreasing are all risk factors of cognitive impairment after cerebral infarction, the MoCA score of patients with cerebral infarction is negatively correlated with the NIHSS score, and positively correlated with the BI score, among them cognitive impairment can directly affect the rehabilitation of neurological function of patients, it is necessary to find and deal with it as early as possible, and pay attention to the early screening of cognitive function of patients, so as to quickly recover the neurological function of patients.