Vascular cognitive impairment is a process which is more frequent in patients with cardiovascular risk factors. The etiology of this kind of impairment could be related to different types of cerebrovascular disorders, given that silent cerebral infarctions or microinfarcts, correlated with small vessel disease, are one of the principal etiologies. Microinfarcts, associated with small vessel diseases, should be considered one of the possible causes of clinical suspicion in patients with cardiovascular risk factors who are asking for help for cognitive complaints. Among the proposed treatments for cognitive impairment there is citicoline. This is an updated review of the possible use of citicoline in the treatment of cognitive impairment.