The study is a scientific review and analysis of a study on the association of brachiocephalic artery stenosis and occlusion with cognitive impairment in the context of chronic cerebral ischemia. The consequences of acute disorders and chronic cerebral ischemia against the background of widespread atherosclerosis and stenotic processes of the carotid arteries lead to various neurological syndromes, including cognitive impairment. Arterial hypertension, atherosclerosis, diabetes mellitus, hyperlipidemia and others prevail among the risk factors, with an emphasis on the vulnerability of elderly patients. Diagnosis includes duplex scanning and angiography, and surgery is recommended for stenosis of more than 70% or unstable plaque. Early detection and treatment can improve cognitive function, and cognitive impairments are classified as mild, moderate, or severe (dementia). Objective. The aim of the study was to analyze the prevalence and impact of the degree and localization of atherosclerotic carotid artery stenosis on cerebral perfusion and cognitive functions in patients with consequences of ischemic strokes examined by the Bureau of Medical and Social Expertise in 2014-2023. The tasks included the analysis of complaints, neurological status, and manifestations of chronic cerebral ischemia (CIM) to assess cognitive impairment in unilateral and bilateral stenosis of the common and internal carotid arteries. Design and methods. A statistical analysis of 5912 cases of the disease was carried out using statistical programs Excel and SPSS. The incidence of cognitive impairment was assessed by gender, disability groups, age characteristics, and clinical syndromes. Pearson's chi-square criteria, Fisher's exact criterion, odds ratio, relative risk, and Kramer's V were used to evaluate the ties. Results. In a group of 4,788 patients (1,872 women, 2,916 men), cognitive impairments were detected in 1,298 (22%), with no significant gender differences (5,7% in women, 6,7% in men). The general structure of impaired mental functions: unexpressed — 11%, moderate — 31%, pronounced — 32%, significantly pronounced — 26%. Among patients without BCA stenosis, cognitive impairment was 5.4%, with stenosis — 10.7% (the chance of development was 2.079 times higher, weak Kramer V association). Men have a 1.2-fold higher chance. By age: young (18-44) — 4.6%, average (45-59) — 6.7%, elderly (60-74) — 6%, older than 74 — 6.7%, with equal frequency after 45 years. Conclusion. The study confirms the effect of brachiocephalic artery stenosis on cognitive function, emphasizing the need for early diagnosis and prevention to prevent the progression of disorders. The results are based on statistically significant data with 95% confidence intervals.