Hypoglycemia is associated with cognitive dysfunction, however, the exact mechanisms have not been elucidated. Our previous study found that severe hypoglycemia can lead to cognitive dysfunction in a type 1 diabetes (T1D) mouse model after severe hypoglycemia. Thus, the aim of this study was to further investigate whether the mechanism of severe hypoglycemia leading to cognitive dysfunction is related to oxidative stress-mediated pericyte loss and blood-brain barrier leakage. A streptozotocin T1D model, using male C57BL/6J mice, was used to induce hypoglycemia. The brain tissue was stained, ROS and ATP were determined, and cognitive function was tested using the Morris water maze. Also, an in vitro glucose deprivation model was constructed. The results show that blood-brain barrier (BBB) leakage after hypoglycemia is associated with excessive activation of oxidative stress and mitochondrial dysfunction due to glucose deprivation/reperfusion. Interventions using the mitochondria-targeted antioxidant Mito-TEMPO in both in vivo and in vitro models reduced mitochondrial oxidative stress, decreased pericyte loss and apoptosis, and attenuated BBB leakage and neuronal damage, ultimately leading to improved cognitive function.