Background: People with arteriosclerotic cardiovascular diseases (ASCVD) frequently use antithrombotic agents and statins. The objective of the study was to explore the prevalence and risk factors of cerebral microbleeds (CMB) in elderly Chinese people with ASCVD.Methods: We prospectively and continuously enrolled 755 participants (≥ 65 years old) in Beijing hospital’s health checkup center from February 1, 2019 to June 30, 2021. MRI protocol and imaging analysis were implemented to identify the CMB, the multivariate binary logistic regression analysis was computed the risk factors of CMB.Results: The average age was 74.95 ± 9.54 years, and the prevalence of CMB was 37.9%. Of those with CMB, 65.0% had strictly lobar CMB, 15.7% had strictly deep CMB, and 19.2% had mixed CMB. Age (odds ratio (OR) 1.43, 95% confidence interval (CI) 1.18–1.73, p < 0.0001), statin use (OR 1.58, 95% CI 1.07–2.32, p = 0.02), and lacunes (OR 1.72, 95% CI 1.09–2.71, p = 0.021) were associated with any CMB. Age (OR 1.34, 95% CI 1.10–1.63, p < 0.0001), statin use (OR 1.72, 95% CI 1.15–2.57, p = 0.008), and white matter hyperintensities (OR 1.68, 95% CI 1.15–2.46, p = 0.008) were associated with lobar CMB. Only lacunes were associated with deep CMB (OR 3.29, 95% CI 1.85–5.87, p < 0.001). Antithrombotic drug use was not associated with CMB (OR 1.16, 95% CI 0.79–1.71, p = 0.457), lobar CMB (OR 1.02, 95% CI 0.68–1.53, p = 0.908), or deep CMB (OR 1.39, 95% CI 0.79–2.44, p = 0.254).Conclusion: Statin use was correlated with lobar CMB but not deep CMB in elderly people with risk factors of ASCVD. In contrast, antithrombotic drug use was not correlated with CMB.