Lacunar stroke and deep intracerebral hemorrhage has long been recognized as manifestations of cerebral small vessel disease (SVD).Since the advent and continuous advancement of MRI technology in 1980s, cerebral SVD has been increasingly recognized to be a highly prevalent condition in the elderly population, associated with other clinical manifestations, including cognitive impairment, dementia, parkinsonism,behavioral disorders, urinary incontinence, and glaucoma.As a whole, cerebral SVD can be considered as one of the commonest brain diseases among the elderly population.The CU-STRIDE study showed that presence of severe SVD increases the odds of incident dementia by more than 3 times over a period of 3 years after stroke.Note that most of the subjects with SVD experienced progressive clinical deterioration despite receiving optimal current stroke preventive measures.Given the prevalence and relevance of cerebral SVD, further studies are needed to untangle the pathophysiological mechanisms of sporadic SVD, so as to develop novel and targeted treatments for preventing progression of SVD and its clinical consequences.