Background: Cerebral small vessel disease (SVD) affects small perforating arteries, causing both lacunar infarction (LI) and confluent white matter lesions (WML). Small vessel disease or lacunar infarct is one of the major stroke subgroups. Lacunar syndromes may be divided into two groups: the classic group (pure motor hemiplegia, pure sensory stroke, ataxic hemiparesis, dysarthria-clumsy hand syndrome, sensorimotor stroke) and the miscellaneous group, including all other lacunar syndromes. We have evaluated risk factors, clinical syndromes, topography, and laboratory findings of 101 consecutive patients with symptomatic lacunar infarcts diagnosed by magnetic resonance imaging. Methods: We analyzed 101 patients with clinical lacunar infarct syndrome who were referred to the neurology department of Qa'em hospital, Mashhad in the northeast of Iran. We assessed clinical features, sex, age, risk factors, radiologic findings and laboratory data of these patients. Results: The pure motor hemiparesis (53.5%) constituted the most usual lacunar syndrome. Mean age of the patients was 63.7± 8.5%. Diabetes mellitus was seen in 14 (13.9%) and hypercholesterolemia in 41 (40.6%) of patients. There were significant differences among ataxic-hemiparesis syndrome and hypertriglyceridemia and CVA history. There was a significant difference between miscellaneous syndromes and valve disease history. Also, there was significant correlation between WML and smoking. Thirty percent of the lesions were detected by CT scan. Conclusion: Sixty percent of the cases were associated with white matter signal changes. Diabetes mellitus were found in 14% of patients. Hypertriglyceridemia, CVA history and valve disease history were associated with some subgroups, but more investigations should be performed for precise assessment of other risk factors.